Larry Chandler

Individual provider Active NPI Community Health Registered Nurse · Payette, ID

NPI 1982180915 · NPPES record last updated Jul 12, 2018

Key facts

NPI
1982180915
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
089003141RN (OR)
Practice address
8512 Washoe Rd
Payette, ID 83661-5424
Phone
(208) 405-5297
NPI assigned
Jul 12, 2018
Sex
Male
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

LicenseStateTypeSpecialty
089003141RNORMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 089003141RN OR Yes

Addresses

Primary practice location

8512 Washoe Rd
Payette, ID 83661-5424

Mailing address

8512 Washoe Rd
Payette, ID 83661-5424
Phone (208) 405-5297

Other providers in Payette, ID

All providers in Payette, ID · Community Health Registered Nurse in Idaho

Sources for this page

Verify at the official NPI Registry.