Provider Demographics
NPI:1194567313
Name:FACHEHOUN, CHIMENE N
Entity type:Individual
Prefix:
First Name:CHIMENE
Middle Name:N
Last Name:FACHEHOUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:EDDYSTONE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1408
Mailing Address - Country:US
Mailing Address - Phone:267-444-8598
Mailing Address - Fax:445-800-8377
Practice Address - Street 1:947 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:EDDYSTONE
Practice Address - State:PA
Practice Address - Zip Code:19022-1408
Practice Address - Country:US
Practice Address - Phone:267-444-8598
Practice Address - Fax:445-800-8377
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA767136013747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant