Healthcare Provider Details

I. General information

NPI: 1205277290
Provider Name (Legal Business Name): ASHLEIGH LAUREN CHAMBERS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3107 13TH ST
SAINT CLOUD FL
34769-5925
US

IV. Provider business mailing address

900 VILLAGE SQUARE XING STE 290
PALM BEACH GARDENS FL
33410-4552
US

V. Phone/Fax

Practice location:
  • Phone: 321-766-4072
  • Fax: 321-805-4072
Mailing address:
  • Phone: 239-360-2792
  • Fax: 239-666-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9294770
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9294770
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: