Individual provider Active NPI

Kristine Chandler, LVN

  • Licensed Vocational Nurse
  • Ridgecrest, CA
National Provider Identifier
1104418243
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
709136 Issued in CA
Practice address
1111 W Inyokern Rd Ste B
Ridgecrest, CA 93555-2370
Phone
(760) 301-6945
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 709136 CA Primary

Addresses

Primary practice location

1111 W Inyokern Rd Ste B
Ridgecrest, CA 93555-2370

Mailing address

1111 W Inyokern Rd Ste B
Ridgecrest, CA 93555-2370
Phone (760) 301-6945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
709136CAMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1104418243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W INYOKERN RD STE B",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935552370",
            "telephone_number": "760-301-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W INYOKERN RD STE B",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935552370",
            "telephone_number": "760-301-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "KRISTINE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "709136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.