Basic Information
Provider Information
NPI: 1245451012
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRICE
FirstName: CHANDRA
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2620 ELM HILL PIKE
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372143108
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2150 WHITNEY AVE
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381276662
CountryCode: US
TelephoneNumber: 9013535440
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/01/2007
LastUpdateDate: 07/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X12675TNN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LP0808X12675TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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