Provider Demographics
NPI:1093993578
Name:CHAMBERS, JENNIFER ANGELLA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANGELLA
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 FLATBUSH AVE
Mailing Address - Street 2:SUITE3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6101
Mailing Address - Country:US
Mailing Address - Phone:718-940-0582
Mailing Address - Fax:718-940-0583
Practice Address - Street 1:1120 FLATBUSH AVE
Practice Address - Street 2:SUITE3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6101
Practice Address - Country:US
Practice Address - Phone:718-940-0582
Practice Address - Fax:718-940-0583
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334292-1261QP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care