Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 523 | AZ |
NPI | 1013115997 |
---|---|
Provider Name | Mrs. Linda Gail Nadler Chamberlain |
First Address | Tucson, AZ 85745-2819 |
Second Address | Tucson, AZ 85745-2819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
106618 | AHCCCS (01) | AZ |