Provider Demographics
NPI:1750885729
Name:CHANDLER, EMONI AMORGAN
Entity type:Individual
Prefix:
First Name:EMONI
Middle Name:AMORGAN
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1810
Mailing Address - Country:US
Mailing Address - Phone:513-208-1420
Mailing Address - Fax:
Practice Address - Street 1:1126 VAN BUREN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1810
Practice Address - Country:US
Practice Address - Phone:513-208-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider