Provider Demographics
NPI:1093065930
Name:CHANDLER, DEVANNE ALESHA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DEVANNE
Middle Name:ALESHA
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9208 KING PALM DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-1328
Mailing Address - Country:US
Mailing Address - Phone:813-828-2273
Mailing Address - Fax:
Practice Address - Street 1:9208 KING PALM DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-1328
Practice Address - Country:US
Practice Address - Phone:808-673-3581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI72584163W00000X
FL11009284363LF0000X
IL041318535163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily