Provider Demographics
NPI:1124763545
Name:NEECE, CHANTEL JOHNSON (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:CHANTEL
Middle Name:JOHNSON
Last Name:NEECE
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 RIVER RD W
Mailing Address - Street 2:
Mailing Address - City:CROZIER
Mailing Address - State:VA
Mailing Address - Zip Code:23039-2504
Mailing Address - Country:US
Mailing Address - Phone:804-247-3371
Mailing Address - Fax:
Practice Address - Street 1:1412 RIVER RD W
Practice Address - Street 2:
Practice Address - City:CROZIER
Practice Address - State:VA
Practice Address - Zip Code:23039-2504
Practice Address - Country:US
Practice Address - Phone:804-247-3371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily