Provider Demographics
NPI:1366720302
Name:CHEW, LONNA
Entity type:Individual
Prefix:
First Name:LONNA
Middle Name:
Last Name:CHEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3837 ELDRON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34286-7455
Mailing Address - Country:US
Mailing Address - Phone:317-495-0000
Mailing Address - Fax:
Practice Address - Street 1:3837 ELDRON AVE
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34286-7455
Practice Address - Country:US
Practice Address - Phone:317-495-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator