Provider Demographics
NPI:1538921242
Name:CHETTA, DONNA MARIA (RN, CHES, CHC)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIA
Last Name:CHETTA
Suffix:
Gender:F
Credentials:RN, CHES, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12395 WHITE OSPREY DR S
Mailing Address - Street 2:
Mailing Address - City:LILLIAN
Mailing Address - State:AL
Mailing Address - Zip Code:36549-5387
Mailing Address - Country:US
Mailing Address - Phone:251-284-1402
Mailing Address - Fax:
Practice Address - Street 1:12395 WHITE OSPREY DR S
Practice Address - Street 2:
Practice Address - City:LILLIAN
Practice Address - State:AL
Practice Address - Zip Code:36549-5387
Practice Address - Country:US
Practice Address - Phone:251-284-1402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
36214174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator