Individual
MR. JAKE MAJURE CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 818-2160
(901) 682-9443
Mailing address
3243 N HILL DR, TUPELO, MS 38804-9787
(601) 562-5934
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
894584
MS
367500000X
Certified Registered Nurse Anesthetist
24813
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
901663
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44-0048
—
TN
Enumeration date
05/04/2018
Last updated
12/10/2024
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