Chavis, Bertha

Chavis, Bertha is an sole proprietor health care provider with primary practice located at 150 Avenue U Nw # C , Winter Haven FL 33881-2156. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Chavis, Bertha can be contacted via phone (407) 927-1980.

Contact Information

Primary practice address
150 Avenue U Nw # C Winter Haven FL 33881-2156
Phone: (407) 927-1980
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN1322231 Florida

Profile Details

NPI number 1679836639
LBN Legal business name Chavis, Bertha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 24th, 2012
Last updated Jun 24th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679836639 NPPES
Florida MEDICAID 686492979

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