Healthcare Provider Details

I. General information

NPI: 1174255137
Provider Name (Legal Business Name): KATHERINE ELIZABETH CHANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WALNUT ST
PHILADELPHIA PA
19107-5191
US

IV. Provider business mailing address

909 WALNUT ST FL 3
PHILADELPHIA PA
19107-5211
US

V. Phone/Fax

Practice location:
  • Phone: 215-503-7008
  • Fax:
Mailing address:
  • Phone: 215-503-7008
  • 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 StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: