Provider Demographics
NPI:1235729690
Name:CHAMBERS, KRISTEN (PMHNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 SE OCEAN BLVD STE 145
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3310
Mailing Address - Country:US
Mailing Address - Phone:954-281-5080
Mailing Address - Fax:
Practice Address - Street 1:300 COLORADO AVE STE 208
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2103
Practice Address - Country:US
Practice Address - Phone:772-302-4352
Practice Address - Fax:866-246-8859
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11010900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health