Provider Demographics
NPI:1750974853
Name:DURHAM, CHANDRA MUSARRA
Entity type:Individual
Prefix:MRS
First Name:CHANDRA
Middle Name:MUSARRA
Last Name:DURHAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3764
Mailing Address - Country:US
Mailing Address - Phone:615-383-2557
Mailing Address - Fax:615-292-2061
Practice Address - Street 1:1710 MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3764
Practice Address - Country:US
Practice Address - Phone:615-383-2557
Practice Address - Fax:615-292-2061
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5112225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist