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General NPI Number Information
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NPI Number | 1376527010
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Entity Type | Individual
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Provider Name | JANE H CHAMBERLAIN APRN
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Gender | Female
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 2215 PORTLAND AVE
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City | LOUISVILLE
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State | KY
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Zip | 40212-1033
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Country | US
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Telephone | 502-774-8631
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Fax | 502-778-3499
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Provider Business Mailing Address
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Address Line | 2215 PORTLAND AVE
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City | LOUISVILLE
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State | KY
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Zip | 40212-1033
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Country | US
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Telephone | 502-774-8631
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Fax | 502-778-3499
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 3000548
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License Number State | KY
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