Provider Demographics
NPI:1538384714
Name:CHALKER, PAULA (CNA)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:CHALKER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 TORRENCE AVE SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-7368
Mailing Address - Country:US
Mailing Address - Phone:321-549-3127
Mailing Address - Fax:321-549-3127
Practice Address - Street 1:900 SE FEDERAL HWY
Practice Address - Street 2:SUITE 305
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3725
Practice Address - Country:US
Practice Address - Phone:772-781-7772
Practice Address - Fax:800-686-8074
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL133361376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide