Healthcare Provider Details

I. General information

NPI: 1255509212
Provider Name (Legal Business Name): JANE M CHANDLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 DUDLEY ST
PROVIDENCE RI
02905-2401
US

IV. Provider business mailing address

455 TOLL GATE ROAD PRC AND CREDENTIALING
WARWICK RI
02886-2759
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-1122
  • Fax: 401-453-7571
Mailing address:
  • Phone: 401-273-0641
  • Fax: 401-273-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPRN01213
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN01213
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: