Individual
SHELLY CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
199 CHERRY ST, MILFORD, CT 06460-3501
(203) 874-2543
(203) 874-2544
Mailing address
1290 SILAS DEANE HWY, HARTFORD HEALTHCARE-CVO, WETHERSFIELD, CT 06109-4337
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
254081
MA
363LF0000X
Family Nurse Practitioner
Primary
12.007315
CT
363LF0000X
Family Nurse Practitioner
2012029067
MO
363LF0000X
Family Nurse Practitioner
3007254
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP4179
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/29/2005
Last updated
01/27/2022
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