Provider Demographics
NPI:1851446298
Name:CHANEY, ROSALIE (APRN)
Entity type:Individual
Prefix:MS
First Name:ROSALIE
Middle Name:
Last Name:CHANEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 GABRIEL ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4720
Mailing Address - Country:US
Mailing Address - Phone:337-235-4310
Mailing Address - Fax:
Practice Address - Street 1:825 KALISTE SALOOM RD
Practice Address - Street 2:BLDG.3, SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4284
Practice Address - Country:US
Practice Address - Phone:337-262-1772
Practice Address - Fax:337-262-5237
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA049556-1209363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1532240Medicaid