Healthcare Provider Details

I. General information

NPI: 1821449315
Provider Name (Legal Business Name): SANDRA TIGUE CHAVIERS C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2016
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 AIRPORT RD SW STE F
HUNTSVILLE AL
35802-4360
US

IV. Provider business mailing address

12935 HIGHWAY 231 431 N
HAZEL GREEN AL
35750-8631
US

V. Phone/Fax

Practice location:
  • Phone: 256-265-0770
  • Fax: 256-265-0777
Mailing address:
  • Phone: 256-828-6766
  • Fax: 866-782-9553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1-076092
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: