Provider Demographics
NPI:1003575689
Name:CHANDLER, MIRANDA (RN)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:RENEE
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:13280 COPELAND ISLAND DR S
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-6614
Mailing Address - Country:US
Mailing Address - Phone:251-366-1849
Mailing Address - Fax:
Practice Address - Street 1:324 COMMONS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6962
Practice Address - Country:US
Practice Address - Phone:251-366-1849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1184897163W00000X
AL1-184897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse