Carlisa Antoinette Chandler
Individual provider Active NPI Private Vehicle · Halifax, VA
NPI 1033670773 · NPPES record last updated Mar 26, 2019
Key facts
- NPI
- 1033670773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Private Vehicle 347C00000X
- License
- T62219932 (VA)
- Practice address
- 1127 Marions TRL
Halifax, VA 24558-3129 - Phone
- (434) 579-4466
- NPI assigned
- Mar 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T62219932 | VA | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | T62219932 | VA | Yes |
Addresses
Primary practice location
1127 Marions TRL
Halifax, VA 24558-3129
Mailing address
502 Cardinal CT
South Boston, VA 24592-1758
Phone (434) 446-5144
Other providers in Halifax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.