Provider Demographics
NPI:1861977951
Name:CHANDLER, TERRI ANNETTE (RN BSN CWON)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:ANNETTE
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:RN BSN CWON
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN BSN CWON
Mailing Address - Street 1:3999 DUTCHMANS LN STE 1D
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4741
Mailing Address - Country:US
Mailing Address - Phone:502-559-1860
Mailing Address - Fax:502-559-1867
Practice Address - Street 1:3999 DUTCHMANS LN STE 1D
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4741
Practice Address - Country:US
Practice Address - Phone:502-559-1860
Practice Address - Fax:502-599-1867
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1056796163WW0000X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
No163WW0000XNursing Service ProvidersRegistered NurseWound Care