Healthcare Provider Details

I. General information

NPI: 1528979267
Provider Name (Legal Business Name): BRIDGETT TIERNEY CHANDLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W MEDICAL PARK DR STE A
LEXINGTON NC
27292-6854
US

IV. Provider business mailing address

536 UNDERPASS RD
ADVANCE NC
27006-7524
US

V. Phone/Fax

Practice location:
  • Phone: 336-248-4413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: