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Organization

BONNE TERRE HEALTHCARE CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY ELIZABETH CHANDLER DNP FNP-C PMHNP-BC (OWNER/PROVIDER)
(573) 723-1100
Entity
Organization

Contact information

Practice address
11 S DIVISION ST STE A, BONNE TERRE, MO 63628-1701
(573) 723-1100
(573) 723-1130
Mailing address
11 S DIVISION ST STE A, BONNE TERRE, MO 63628-1701
(573) 723-1100
(573) 723-1130

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
363LF0000X
Family Nurse Practitioner
Primary
363LP0200X
Pediatric Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
363LP2300X
Primary Care Nurse Practitioner
363LW0102X
Women's Health Nurse Practitioner

Other

Enumeration date
10/02/2019
Last updated
02/25/2024
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