Provider Demographics
NPI:1104990597
Name:CHAMBERS, MARY BETH (DNP)
Entity type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19325 KENNEMER DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5017
Mailing Address - Country:US
Mailing Address - Phone:512-990-5294
Mailing Address - Fax:
Practice Address - Street 1:27873 CHERRY CREEK DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91354-1355
Practice Address - Country:US
Practice Address - Phone:512-826-2787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649615364SA2200X
CA4735364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health