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General NPI Number Information
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NPI Number | 1881957710
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Entity Type | Individual
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Provider Name | FONDA CHANDLER RN
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Gender | Female
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 301 W MAIN ST
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City | WINNFIELD
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State | LA
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Zip | 71483-2786
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Country | US
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Telephone | 318-628-2148
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Fax | 318-628-6822
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Provider Business Mailing Address
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Address Line | 1378 HIGHWAY 505
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City | DODSON
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State | LA
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Zip | 71422-3546
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Country | US
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Telephone | 318-628-3079
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Fax |
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN041436
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License Number State | LA
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