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Mr. Jerry Idiculla Chandy, NP
Adult Health Nurse Practitioner in Trenton, Michigan
NPI 1023447695

Jerry Idiculla Chandy is an Adult Health Nurse Practitioner based in Trenton, MI and is specialized in Adult Health. Jerry Idiculla Chandy practices in Trenton, MI and has the professional credentials of NP. The NPI Number for Jerry Idiculla Chandy is 1023447695 and holds a License No. 4704276954 (Michigan).

The current practice location address for Jerry Idiculla Chandy is 1675 Kingsway Ct Ste 1, Trenton, MI and can be reached out via phone at 734-676-8530.

Location: 1675 Kingsway Ct Ste 1, Trenton, MI, 48183-1958
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023447695
Provider Name
Jerry Idiculla Chandy
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
1675 Kingsway Ct Ste 1, Trenton, MI, 48183-1958
Phone Number
734-676-8530
Fax Number
Provider Enumeration Date
11/05/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1675 Kingsway Ct Ste 1
City
Trenton
State
Michigan
Zip
48183-1958
Phone Number
734-676-8530
Fax Number
person
Provider Business Mailing Address Details
Address
1675 Kingsway Ct Ste 1
City
Trenton
State
Michigan
Zip
48183-1958
Phone Number
734-676-8530
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
4704276954 (Michigan)
Definition
Definition to come...
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