Provider Demographics
NPI:1063644037
Name:CHANDLER, BRIDGETT ELIZABETH (LPN)
Entity Type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:ELIZABETH
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 ASHTREE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1554
Mailing Address - Country:US
Mailing Address - Phone:513-886-0186
Mailing Address - Fax:
Practice Address - Street 1:4675 ASHTREE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-1554
Practice Address - Country:US
Practice Address - Phone:513-886-0186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.130699164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse