Provider Demographics
NPI:1215509625
Name:HONEYWOOD, CHANDA LYNNE
Entity type:Individual
Prefix:
First Name:CHANDA
Middle Name:LYNNE
Last Name:HONEYWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HONEYWOOD HEALTHCARE
Other - Middle Name:
Other - Last Name:LLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2508 TANGLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36618-4852
Mailing Address - Country:US
Mailing Address - Phone:504-621-7011
Mailing Address - Fax:
Practice Address - Street 1:1111 S BELTLINE HWY, STE 116D
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606
Practice Address - Country:US
Practice Address - Phone:504-621-7011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-115940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty