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CHRISTOPHER DYLAN CHAMBLISS APRN
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1801489497
Individual Registrant: CHRISTOPHER DYLAN CHAMBLISS APRN
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
199 S US HIGHWAY 17 STE A EAST PALATKA, FL 32131-6071 US
Tel: 386-312-5250 Fax: --
Tel: 386-312-5250 Fax: --
Contact information for business:
1667 N CLYDE MORRIS BLVD STE 2 DAYTONA BEACH, FL 32117-5500 US
Tel: 386-274-4840 Fax: 386-256-3008
Tel: 386-274-4840 Fax: 386-256-3008
Registration Information:
NPI: 1801489497
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | FL | APRN11011662 |
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | FL | 11011662 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
