Individual
MISS INDIRA MICHELLE CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 LUPTON AVE, WOODBURY, NJ 08096-5901
(856) 537-5081
Mailing address
1 LUPTON AVE, WOODBURY, NJ 08096-5901
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00470400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0422169
—
NJ
Enumeration date
11/08/2013
Last updated
11/15/2024
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