Provider Demographics
NPI:1306943949
Name:CHANDLER, DANA (CRNA)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:200 CLINIC DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1661
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1644
Practice Address - Country:US
Practice Address - Phone:270-825-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1809A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1809AOtherLICENSE
000000044313OtherBCBS PROVIDER NUMBER
KY74431057Medicaid
0374588Medicare PIN
000000044313OtherBCBS PROVIDER NUMBER
KYP400020187Medicare PIN
R38181Medicare UPIN