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Individual
MS. KELLY C CHANDLER
Active
Individual
MS. KELLY C CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60291128
WA
363L00000X
Nurse Practitioner
Primary
AP61004254
WA
363LF0000X
Family Nurse Practitioner
AP61004254
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720371669
GROUP PRACTICE NPI
IL
05
—
1942714571
—
WA
01
—
DS2377
RRMC GROUP PTAN
IL
Enumeration date
11/17/2017
Last updated
10/07/2020
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