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NPI Code Detail

MEDICARE: ANGELA BLANE CHAMBERS PA-C

MEDICARE: ANGELA BLANE CHAMBERS PA-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
1363AM0700XMedical Physician Assistant2003NE

General Provider Information

NPI Number : 1790972719
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA BLANE CHAMBERS PA-C
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12856 DEAUVILLE DR
Second Line :
City : OMAHA
State : NE
Zip : 68137-3204
Country : US
Telephone Number : 402-895-2266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2007
Last Update Date : 07/08/2022

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Directions to “ ANGELA BLANE CHAMBERS PA-C” Practice Location

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