Provider Demographics
NPI:1437728169
Name:CHAMBERS, MARANDA JO (RN)
Entity Type:Individual
Prefix:
First Name:MARANDA
Middle Name:JO
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARANDA
Other - Middle Name:JO
Other - Last Name:DENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2925 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-9141
Mailing Address - Country:US
Mailing Address - Phone:502-544-5489
Mailing Address - Fax:
Practice Address - Street 1:2424 SIR BARTON WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2521
Practice Address - Country:US
Practice Address - Phone:859-233-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1148979163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health