Provider Demographics
NPI:1932413069
Name:CHANDLER, ROBINETTE
Entity Type:Individual
Prefix:
First Name:ROBINETTE
Middle Name:
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 1:12364 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-8040
Mailing Address - Country:US
Mailing Address - Phone:602-460-9267
Mailing Address - Fax:623-877-8395
Practice Address - Street 1:12364 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-8040
Practice Address - Country:US
Practice Address - Phone:602-460-9267
Practice Address - Fax:623-877-8395
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24471733747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant