Provider Demographics
NPI:1548515935
Name:CHAMBERLAIN, CRIS RONALD (NP-C)
Entity type:Individual
Prefix:MR
First Name:CRIS
Middle Name:RONALD
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 N HOSPITAL DR STE 5
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4211
Mailing Address - Country:US
Mailing Address - Phone:435-637-4590
Mailing Address - Fax:435-637-4598
Practice Address - Street 1:280 N HOSPITAL DR STE 5
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4211
Practice Address - Country:US
Practice Address - Phone:435-637-4590
Practice Address - Fax:435-637-4598
Is Sole Proprietor?:No
Enumeration Date:2012-07-21
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01992363LF0000X
UT4852218-8900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily