Provider Demographics
NPI:1093303711
Name:CHAMBERS, RHONDA EVELYN
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:EVELYN
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1324
Mailing Address - Country:US
Mailing Address - Phone:207-952-0241
Mailing Address - Fax:207-454-8745
Practice Address - Street 1:11 OCEAN ST
Practice Address - Street 2:
Practice Address - City:JONESPORT
Practice Address - State:ME
Practice Address - Zip Code:04649-3376
Practice Address - Country:US
Practice Address - Phone:207-497-4138
Practice Address - Fax:207-497-4139
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERCD39158310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility