Basic Information
| Provider Information | |||||||||
| NPI: | 1104587369 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CHIEU | ||||||||
| FirstName: | KELLIE | ||||||||
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| Credential: | CPO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3147 BIOINFORMATICS BUILDING, CB# 7745 | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199669166 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 MANNING DR., CB# 7745 | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849745700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2022 | ||||||||
| LastUpdateDate: | 01/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Z00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Orthotist | 224P00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Prosthetist |
No ID Information.