MEDICARE: AMBER CHANEY

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	163W00000X	Registered Nurse	1136009	KY

General Provider Information

NPI Number	:	1538615968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER CHANEY

Provider Business Mailing Address
First Line	:	310 STONE COAL CREEK RD
Second Line	:
City	:	BOONEVILLE
State	:	KY
Zip	:	41314-9504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 STONE COAL CREEK RD
Second Line	:
City	:	BOONEVILLE
State	:	KY
Zip	:	41314-9504
Country	:	US
Telephone Number	:	606-272-2792
Fax Number	:

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

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	08/26/2016

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Directions to “ AMBER CHANEY ” Practice Location

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