Individual
FANTASIA IZOLIA CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
575 STONEWALL JACKSON BLVD, ORANGEBURG, SC 29115-7250
(864) 316-8984
Mailing address
159 CHANSTALAS RD, SALLEY, SC 29137-9435
(803) 608-8938
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
001663
GA
363LF0000X
Family Nurse Practitioner
Primary
21694
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5280
—
SC
Enumeration date
06/06/2018
Last updated
10/15/2025
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