Provider Demographics
NPI:1497573273
Name:CARRINGTON, CHANEL
Entity type:Individual
Prefix:
First Name:CHANEL
Middle Name:
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 GITTINGS ST STE 100B
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-6155
Mailing Address - Country:US
Mailing Address - Phone:757-895-1449
Mailing Address - Fax:
Practice Address - Street 1:707 GITTINGS ST STE 100B
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-6155
Practice Address - Country:US
Practice Address - Phone:757-895-1449
Practice Address - Fax:757-782-8100
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002100506164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse