MEDICARE: MRS. MARIE ELIZABETH CHAMBERS CNP

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
1	363LA2200X	Adult Health Nurse Practitioner	APRN.CNP.09140	OH

General Provider Information

NPI Number	:	1063538783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIE ELIZABETH CHAMBERS CNP

Provider Business Mailing Address
First Line	:	2621 GLADWIN CT
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-5243
Country	:	US
Telephone Number	:	419-265-3055
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 MIAMI VALLEY DR STE 550
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-4779
Country	:	US
Telephone Number	:	937-438-7500
Fax Number	:	937-438-7555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	03/17/2018

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