Provider Demographics
NPI:1841327038
Name:CHANDLER, BEVERLY H (ARNP)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:H
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:BEVERLY
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:621 W BALDWIN RD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405
Mailing Address - Country:US
Mailing Address - Phone:850-747-3661
Mailing Address - Fax:850-747-0194
Practice Address - Street 1:621 W BALDWIN RD STE A
Practice Address - Street 2:STE 102
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3364
Practice Address - Country:US
Practice Address - Phone:850-747-3661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3115452363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306190600Medicaid
FL11576OtherBCBS