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NPI Code Detail

MEDICARE: MISS NELLIE SUE CHAMBLEE FNP-C

MEDICARE: MISS NELLIE SUE CHAMBLEE FNP-C
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
1363LF0000XFamily Nurse Practitioner5006518NC
2363LF0000XFamily Nurse Practitioner0024168452VA

General Provider Information

NPI Number : 1508199860
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS NELLIE SUE CHAMBLEE FNP-C
Provider Business Mailing Address
First Line : 445 CHARLES H DIMMOCK PKWY STE 100
Second Line :
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-2990
Country : US
Telephone Number : 804-520-1764
Fax Number : 804-520-1764
Provider Business Practice Location Address
First Line : 445 CHARLES H DIMMOCK PKWY STE 100
Second Line :
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-2990
Country : US
Telephone Number : 804-520-1764
Fax Number : 804-520-1764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2009
Last Update Date : 06/13/2022

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Directions to “ MISS NELLIE SUE CHAMBLEE FNP-C” Practice Location

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