Provider Demographics
NPI:1316304736
Name:CHANDLER, JERI ROSE (CRNA)
Entity type:Individual
Prefix:
First Name:JERI
Middle Name:ROSE
Last Name:CHANDLER
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7477 FARMERS RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-3223
Mailing Address - Country:US
Mailing Address - Phone:850-554-9572
Mailing Address - Fax:
Practice Address - Street 1:7477 FARMERS RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-3223
Practice Address - Country:US
Practice Address - Phone:850-554-9572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-16
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9209779367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered