Provider Demographics
NPI:1912428582
Name:STEPHENS, CHANDLER SUZANNE (ATC, NREMT-B)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:SUZANNE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:ATC, NREMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 REINHARDT DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4251
Mailing Address - Country:US
Mailing Address - Phone:337-482-5403
Mailing Address - Fax:337-262-2215
Practice Address - Street 1:202 REINHARDT DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4251
Practice Address - Country:US
Practice Address - Phone:337-482-5403
Practice Address - Fax:337-262-2215
Is Sole Proprietor?:No
Enumeration Date:2017-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer