Provider Demographics
NPI:1073730032
Name:DOHERTY-CHANDLER, DIANE ARLENE (RN, MS, CPNP, NNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:ARLENE
Last Name:DOHERTY-CHANDLER
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Gender:F
Credentials:RN, MS, CPNP, NNP-BC
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Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-533-4748
Practice Address - Street 1:743 SPRING ST NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3715
Practice Address - Country:US
Practice Address - Phone:770-535-3611
Practice Address - Fax:770-535-7092
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2023-05-31
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Provider Licenses
StateLicense IDTaxonomies
GARN112295363LN0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics