Provider Demographics
NPI:1487976296
Name:JACQUES-HYPPOLITE, CHANTAL (LPN)
Entity type:Individual
Prefix:MRS
First Name:CHANTAL
Middle Name:
Last Name:JACQUES-HYPPOLITE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1362 OCEAN AVE
Mailing Address - Street 2:APT. 1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3268
Mailing Address - Country:US
Mailing Address - Phone:347-836-0158
Mailing Address - Fax:
Practice Address - Street 1:1362 OCEAN AVE
Practice Address - Street 2:APT. 1B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3268
Practice Address - Country:US
Practice Address - Phone:347-836-0158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-20
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250606-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse