Healthcare Provider Details

I. General information

NPI: 1720087471
Provider Name (Legal Business Name): BARBARA JEAN CHANDLER PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 B PEACHTREE DUNWOODY RD NE SUITE B- 420
ATLANTA GA
30328-5382
US

IV. Provider business mailing address

5901 - B PEACHTREE DUNWOODY RD NE SUITE B-420
ATLANTA GA
30328-5382
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-9751
  • Fax: 678-990-5763
Mailing address:
  • Phone: 404-252-9751
  • Fax: 678-990-5763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN061123
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: