Provider Demographics
NPI:1023348679
Name:CHAMBERS, MARY BETH (RNC)
Entity type:Individual
Prefix:MRS
First Name:MARY BETH
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 QUEEN ANNES GATE
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2640
Mailing Address - Country:US
Mailing Address - Phone:440-835-7264
Mailing Address - Fax:
Practice Address - Street 1:1620 QUEEN ANNES GATE
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2640
Practice Address - Country:US
Practice Address - Phone:440-835-7264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-161068163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse