Provider Demographics
NPI:1821984527
Name:SUBERANO, CHANDRA T
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:T
Last Name:SUBERANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7012
Mailing Address - Country:US
Mailing Address - Phone:870-573-7037
Mailing Address - Fax:
Practice Address - Street 1:507 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7012
Practice Address - Country:US
Practice Address - Phone:870-573-7037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program