Healthcare Provider Details

I. General information

NPI: 1356615249
Provider Name (Legal Business Name): SHERI C CHANDLER NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2012
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 GREEN VALLEY RD
GREENSBORO NC
27408-7021
US

IV. Provider business mailing address

2670 BROOKE MEADOWS DR
BROWNS SUMMIT NC
27214-9819
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-6865
  • Fax:
Mailing address:
  • Phone: 336-295-3113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number930128
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: