Provider Demographics
NPI:1811509516
Name:CHAMBERS, MARSHA DIANE (RN)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:DIANE
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:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-0041
Mailing Address - Country:US
Mailing Address - Phone:304-822-4097
Mailing Address - Fax:304-822-7322
Practice Address - Street 1:HAMPSHIRE COUNTY COMMITTEE ON AGING
Practice Address - Street 2:24781 NORTHWESTERN PIKE
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757
Practice Address - Country:US
Practice Address - Phone:304-822-4097
Practice Address - Fax:304-822-7322
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV28782171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator