Provider Demographics
NPI:1841999661
Name:CHEVALIER, CHRISTA NICHOLE (RN)
Entity type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:NICHOLE
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 LIBERTY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3766
Mailing Address - Country:US
Mailing Address - Phone:413-747-0705
Mailing Address - Fax:
Practice Address - Street 1:21 KENWOOD ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1973
Practice Address - Country:US
Practice Address - Phone:142-341-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2317600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse