Chanel Maxwell, FNP
Family Medicine in Ruskin, FL. Individual provider (NPI-1).
NPI number1649150525
StatusActive
Last updated in NPPESSep 3, 2025
Details
- NPI
- 1649150525
- Entity type
- Individual (NPI-1)
- Name
- Chanel Maxwell
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 3, 2025
- Certification date
- Sep 3, 2025
- Last updated
- Sep 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 11040421 | FL | Yes |
Practice location
1019 Wynnmere Walk AveRuskin, FL 33570-2067
Phone 347-982-7572
Mailing address
1019 Wynnmere Walk AveRuskin, FL 33570-2067
Phone 347-982-7572
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