| NPI | 1104636539 |
|---|---|
| Former Name | CHANCIE WARREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209031536) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041417657) |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-03-05 |