Healthcare Provider Details

I. General information

NPI: 1679364640
Provider Name (Legal Business Name): CHANDLER'S RDL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W CENTER ST
ACKERMAN MS
39735-9017
US

IV. Provider business mailing address

140 W CENTER ST
ACKERMAN MS
39735-9017
US

V. Phone/Fax

Practice location:
  • Phone: 662-285-7700
  • Fax:
Mailing address:
  • Phone: 662-285-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ERIN CHANDLER
Title or Position: OWNER
Credential: FNP
Phone: 662-285-7700