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NPI Code Detail

MEDICARE: MRS. DEVANNE ALESHA CHANDLER NP

MEDICARE: MRS. DEVANNE ALESHA CHANDLER NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse72584HI
2363LF0000XFamily Nurse Practitioner11009284FL
3163W00000XRegistered Nurse041318535IL

General Provider Information

NPI Number : 1093065930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEVANNE ALESHA CHANDLER NP
Provider Business Mailing Address
First Line : 9208 KING PALM DR
Second Line :
City : TAMPA
State : FL
Zip : 33619-1328
Country : US
Telephone Number : 813-828-2273
Fax Number :
Provider Business Practice Location Address
First Line : 9208 KING PALM DR
Second Line :
City : TAMPA
State : FL
Zip : 33619-1328
Country : US
Telephone Number : 808-673-3581
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2012
Last Update Date : 07/16/2021

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