Provider Demographics
NPI:1033507991
Name:CHANDLER, WENDY JANELLE (ARNP, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JANELLE
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:559 VINCENT ST
Mailing Address - Street 2:
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1541
Mailing Address - Country:US
Mailing Address - Phone:719-556-2273
Mailing Address - Fax:866-867-7926
Practice Address - Street 1:559 VINCENT STREET
Practice Address - Street 2:ATTN: 21 MDOS/SGOF-FAMILY PRACTICE
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-2273
Practice Address - Fax:866-867-7926
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60527006363LF0000X
COAPN.0993857-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty