Provider Demographics
NPI:1972015824
Name:CHANEY, AMBER L (RDN LD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:CHANEY
Suffix:
Gender:F
Credentials:RDN LD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:CHANEY
Other - Last Name:SPEEGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2062 SHENANDOAH DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-6253
Mailing Address - Country:US
Mailing Address - Phone:662-293-7266
Mailing Address - Fax:662-293-6255
Practice Address - Street 1:703 ALCORN DR STE 102
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9302
Practice Address - Country:US
Practice Address - Phone:662-286-2522
Practice Address - Fax:662-293-4288
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD1825133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered