Healthcare Provider Details

I. General information

NPI: 1538081757
Provider Name (Legal Business Name): AMBER NICOLE CHANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 W ADMIRAL BLVD
TULSA OK
74127-8516
US

IV. Provider business mailing address

1416 W ADMIRAL BLVD
TULSA OK
74127-8516
US

V. Phone/Fax

Practice location:
  • Phone: 918-568-7201
  • Fax:
Mailing address:
  • Phone: 918-568-7201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: