Provider Demographics
NPI:1154066694
Name:YEAGER, CHANTEL RENEE (FNP)
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:RENEE
Last Name:YEAGER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22350 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:COURTLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23837-1143
Mailing Address - Country:US
Mailing Address - Phone:757-556-4297
Mailing Address - Fax:
Practice Address - Street 1:22350 LINDEN ST
Practice Address - Street 2:
Practice Address - City:COURTLAND
Practice Address - State:VA
Practice Address - Zip Code:23837-1143
Practice Address - Country:US
Practice Address - Phone:757-556-4297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily