Provider Demographics
NPI:1588374425
Name:CHANDLER, KEELY DAVIS (APRN-FNP)
Entity type:Individual
Prefix:MRS
First Name:KEELY
Middle Name:DAVIS
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 11TH CIR STE 203
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4889
Mailing Address - Country:US
Mailing Address - Phone:772-563-0930
Mailing Address - Fax:
Practice Address - Street 1:3735 11TH CIR STE 203
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4889
Practice Address - Country:US
Practice Address - Phone:772-563-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023337363LF0000X
FLRN9593482163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse