Provider Demographics
NPI:1962793141
Name:GASS, CHENOA JACQUELINE (RN CDE)
Entity type:Individual
Prefix:
First Name:CHENOA
Middle Name:JACQUELINE
Last Name:GASS
Suffix:
Gender:F
Credentials:RN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:806 ACQUONI ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719
Mailing Address - Country:US
Mailing Address - Phone:828-497-1999
Mailing Address - Fax:828-497-8194
Practice Address - Street 1:806 ACQUONI ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719
Practice Address - Country:US
Practice Address - Phone:828-497-1999
Practice Address - Fax:828-497-8194
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172385163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse