Provider Demographics
NPI:1215247416
Name:DEBENHAM, CHANTELL RENEE (ARNP)
Entity type:Individual
Prefix:
First Name:CHANTELL
Middle Name:RENEE
Last Name:DEBENHAM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 3600 AVE
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-6044
Mailing Address - Country:US
Mailing Address - Phone:785-479-6401
Mailing Address - Fax:
Practice Address - Street 1:981 3600 AVE
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-6044
Practice Address - Country:US
Practice Address - Phone:785-576-9990
Practice Address - Fax:785-576-9995
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75253-022363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner