Individual
TRAVIS CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
1900 CONANT AVE, BURLEY, ID 83318-2333
(208) 670-5922
Mailing address
1900 CONANT AVE, BURLEY, ID 83318-2333
(208) 670-5922
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
27663
ID
363LG0600X
Gerontology Nurse Practitioner
27663
ID
363LP2300X
Primary Care Nurse Practitioner
Primary
27663
ID
Other
Enumeration date
04/28/2017
Last updated
04/28/2017
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