Provider Demographics
NPI:1992347538
Name:CHANEY, REBECCA JANE (CNA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JANE
Last Name:CHANEY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3634 MORRIS FARM DR APT 1C
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-8967
Mailing Address - Country:US
Mailing Address - Phone:336-609-0789
Mailing Address - Fax:
Practice Address - Street 1:3638 MORRIS FARM DR APT 1B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-8970
Practice Address - Country:US
Practice Address - Phone:336-609-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
YPA102678913OtherBCBS INSURANCE
NCYPA102678913OtherINSURANCE