Provider Demographics
NPI:1730684374
Name:JOSEPH, CHANTAL VIVIANE (ARNP)
Entity type:Individual
Prefix:
First Name:CHANTAL
Middle Name:VIVIANE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CHANTAL
Other - Middle Name:V
Other - Last Name:TELUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6901 NW 84TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-5042
Mailing Address - Country:US
Mailing Address - Phone:954-200-1312
Mailing Address - Fax:
Practice Address - Street 1:6901 NW 84TH ST
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5042
Practice Address - Country:US
Practice Address - Phone:954-200-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9237074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily