Courtney Vishae Chatman, BOARD CERTIFIED CNA

Individual provider Active NPI Nurse's Aide · Kingstree, SC

NPI 1114799459 · NPPES record last updated Oct 30, 2023

Key facts

NPI
1114799459
Entity type
Individual (NPI type 1)
Primary specialty
Nurse's Aide 376K00000X
Practice address
927 Eastland Ave
Kingstree, SC 29556-2565
Phone
(803) 543-5162
NPI assigned
Oct 30, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide
Group: 193400000X SINGLE SPECIALTY GROUP
376K00000X Yes

Addresses

Primary practice location

927 Eastland Ave
Kingstree, SC 29556-2565

Mailing address

1049 NE Miles Rd
Blythewood, SC 29016-8148
Phone (803) 543-5162

Other providers in Kingstree, SC

All providers in Kingstree, SC · Nurse's Aide in South Carolina

Sources for this page

Verify at the official NPI Registry.