Basic Information
| Provider Information | |||||||||
| NPI: | 1427260967 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHANDLER | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | K. | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 720 S COLORADO BLVD | ||||||||
| Address2: | SUITE 220A | ||||||||
| City: | GLENDALE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802461912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035848231 | ||||||||
| FaxNumber: | 8662100907 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 S POTOMAC | ||||||||
| Address2: | SUITE 225 | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800124514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038735245 | ||||||||
| FaxNumber: | 3038735240 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 06/26/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0102X | 68516 | CO | N | Nursing Service Providers | Registered Nurse | Maternal Newborn | 176B00000X | 1384 | CO | Y | Other Service Providers | Midwife |
ID Information
| ID | Type | State | Issuer | Description | MC0297487 | 01 | DEA | OTHER |