Individual
JACQUELINE CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8101 CLEARVISTA PKWY STE 200, INDIANAPOLIS, IN 46256-4675
(317) 621-5390
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28207298A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006910A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005412
—
IN
Enumeration date
01/31/2017
Last updated
11/05/2024
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