Provider Demographics
NPI:1194191858
Name:DOZIER, CHANDRA DENISE II (LPN)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:DENISE
Last Name:DOZIER
Suffix:II
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 1:306 25TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8430
Mailing Address - Country:US
Mailing Address - Phone:706-505-1345
Mailing Address - Fax:706-649-6780
Practice Address - Street 1:306 25TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8430
Practice Address - Country:US
Practice Address - Phone:706-505-1345
Practice Address - Fax:706-649-6780
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN060368164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse