Provider Demographics
NPI:1427261619
Name:CHENAULT, BARBARA (CERT SURGICAL ASST)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:CHENAULT
Suffix:
Gender:F
Credentials:CERT SURGICAL ASST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18190 E IDA DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5906
Mailing Address - Country:US
Mailing Address - Phone:720-876-2072
Mailing Address - Fax:720-876-2073
Practice Address - Street 1:18190 E IDA DR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5906
Practice Address - Country:US
Practice Address - Phone:720-876-2072
Practice Address - Fax:720-876-2073
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
CO93-112363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical