MEDICARE: DEBENIQUE CHANDLER- MCCRAY 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
1	363LF0000X	Family Nurse Practitioner	908269	MS

General Provider Information

NPI Number	:	1235087859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBENIQUE CHANDLER- MCCRAY NP

Provider Business Mailing Address
First Line	:	124 COASTAL OAK
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-4470
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 COASTAL OAK
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-4470
Country	:	US
Telephone Number	:	601-818-0436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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