Provider Demographics
NPI:1447030150
Name:CHANDLER, AMBER THIBODEAUX (FNP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:THIBODEAUX
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30952 S SUMMERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-1588
Mailing Address - Country:US
Mailing Address - Phone:225-937-4575
Mailing Address - Fax:
Practice Address - Street 1:100 BON TEMPS ROULE
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-2555
Practice Address - Country:US
Practice Address - Phone:985-322-3005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA226509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily