Provider Demographics
NPI:1295386647
Name:CHAMBERS, JUDY LYNN
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:LYNN
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:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:HAWESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42348-0446
Mailing Address - Country:US
Mailing Address - Phone:270-927-6475
Mailing Address - Fax:
Practice Address - Street 1:300 PELLVILLE ST
Practice Address - Street 2:
Practice Address - City:HAWESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42348
Practice Address - Country:US
Practice Address - Phone:270-927-6475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider