Healthcare Provider Details

I. General information

NPI: 1730876491
Provider Name (Legal Business Name): CHRISTALYNN NICOLE CHAMBERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6308 SAINT CLAIR DR NE APT 6308
ATLANTA GA
30329-2677
US

IV. Provider business mailing address

6308 SAINT CLAIR DR NE APT 6308
ATLANTA GA
30329-2677
US

V. Phone/Fax

Practice location:
  • Phone: 870-692-9123
  • Fax:
Mailing address:
  • Phone: 870-692-9123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number216341
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number216341
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number216341
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number216341
License Number StateAR
# 5
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number216341
License Number StateAR
# 6
Primary TaxonomyN
Taxonomy Code163WC2100X
TaxonomyContinence Care Registered Nurse
License Number216341
License Number StateAR
# 7
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number216341
License Number StateAR
# 8
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number216341
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: