Provider Demographics
NPI:1336652767
Name:CHANDLER, BRANDY ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:ELIZABETH
Last Name:CHANDLER
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:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:WV
Mailing Address - Zip Code:25043-0147
Mailing Address - Country:US
Mailing Address - Phone:304-587-7301
Mailing Address - Fax:304-587-2464
Practice Address - Street 1:122 CENTER ST
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:WV
Practice Address - Zip Code:25043-7046
Practice Address - Country:US
Practice Address - Phone:304-587-7301
Practice Address - Fax:304-587-2464
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV82509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily