Basic Information
| Provider Information | |||||||||
| NPI: | 1720144793 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHANDLER | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | BETH | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 823 CENTER AVE | ||||||||
| Address2: | |||||||||
| City: | PAYETTE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836612535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2086423396 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 823 CENTER AVE | ||||||||
| Address2: | |||||||||
| City: | PAYETTE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836612535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2086423396 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 05/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 45817 | ID | N | Nursing Service Providers | Registered Nurse | 163WC0200X | 9220812 | FL | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 363LG0600X | CNP81650 | ID | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.