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General NPI Number Information
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NPI Number | 1205408820
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Entity Type | Individual
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Provider Name | CHANDLER B MCKINNEY PA
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Gender | Female
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1317 S STATE HIGHWAY 32
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City | EL DORADO SPRINGS
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State | MO
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Zip | 64744-2302
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Country | US
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Telephone | 417-876-3333
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Fax | 417-876-4509
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Provider Business Mailing Address
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Address Line | 1401 S PARK ST
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City | EL DORADO SPRINGS
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State | MO
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Zip | 64744-2037
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Country | US
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Telephone | 417-876-2511
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Fax | 417-876-3812
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2021021450
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License Number State | MO
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