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NPI Code Detail

MEDICARE: STEPHANIE E CHANDLER CRNP

MEDICARE: STEPHANIE E CHANDLER CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1364SF0001XFamily Health Clinical Nurse SpecialistSP014653PA
2364SF0001XFamily Health Clinical Nurse SpecialistRN256117GA

General Provider Information

NPI Number : 1023406162
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE E CHANDLER CRNP
Provider Business Mailing Address
First Line : 1631 HIGHWAY 20 W
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-7311
Country : US
Telephone Number : 770-288-2822
Fax Number : 770-692-8177
Provider Business Practice Location Address
First Line : 1631 HIGHWAY 20 W
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-7311
Country : US
Telephone Number : 770-288-2822
Fax Number : 770-692-8177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2014
Last Update Date : 01/12/2026

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