Provider Demographics
NPI:1386321453
Name:BATTLE, CHAUNTIA M (LPN)
Entity type:Individual
Prefix:MISS
First Name:CHAUNTIA
Middle Name:M
Last Name:BATTLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 MILLBANK ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1955
Mailing Address - Country:US
Mailing Address - Phone:585-503-1588
Mailing Address - Fax:
Practice Address - Street 1:143 MILLBANK ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1955
Practice Address - Country:US
Practice Address - Phone:585-503-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346176164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse