Basic Information
Provider Information
NPI: 1619546363
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAMBERS
FirstName: RHONDA
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5000 COX RD
Address2:  
City: GLEN ALLEN
State: VA
PostalCode: 230609263
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2205 N PARHAM RD
Address2:  
City: RICHMOND
State: VA
PostalCode: 232293161
CountryCode: US
TelephoneNumber: 8042702150
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/17/2021
LastUpdateDate: 09/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X0024181651VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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