Provider Demographics
NPI:1689342495
Name:CHAMBERS, VERNISHA TRANITA (RN)
Entity Type:Individual
Prefix:
First Name:VERNISHA
Middle Name:TRANITA
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 CARMICHAEL WAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3671
Mailing Address - Country:US
Mailing Address - Phone:334-544-0123
Mailing Address - Fax:
Practice Address - Street 1:1228 CARMICHAEL WAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3671
Practice Address - Country:US
Practice Address - Phone:334-544-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-152838372600000X, 3747P1801X, 163WA2000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL82-4101678Medicaid
AL82-410678Medicaid