Provider Demographics
NPI:1467140020
Name:CHANDLER, NORMA JEAN (APRN)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 CARMELLA WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-9137
Mailing Address - Country:US
Mailing Address - Phone:270-791-3224
Mailing Address - Fax:
Practice Address - Street 1:2909 CARMELLA WAY
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9137
Practice Address - Country:US
Practice Address - Phone:270-791-3224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028769363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily