Provider Demographics
NPI:1003422270
Name:CHANDLER, VICTORIA W (APRN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:W
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:WEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9301 DAYFLOWER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7585
Mailing Address - Country:US
Mailing Address - Phone:502-326-8588
Mailing Address - Fax:502-326-8589
Practice Address - Street 1:9301 DAYFLOWER ST STE 100
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-7585
Practice Address - Country:US
Practice Address - Phone:502-326-8588
Practice Address - Fax:502-326-8589
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015128363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner