Provider Demographics
NPI:1043198393
Name:NORDEN, CHANEL'E (PHARMACIST)
Entity type:Individual
Prefix:
First Name:CHANEL'E
Middle Name:
Last Name:NORDEN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:CHANEL'E
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:110 INTEGRA RESERVE LN APT 302
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-9839
Mailing Address - Country:US
Mailing Address - Phone:386-456-7712
Mailing Address - Fax:
Practice Address - Street 1:3010 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32141-5903
Practice Address - Country:US
Practice Address - Phone:386-427-5208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS69282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist