| NPI | 1508193798 |
|---|---|
| Former Name | SHANNON CHANDLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 14379) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: VA 0024170316) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2014-05-09 |