Healthcare Provider Details

I. General information

NPI: 1376474494
Provider Name (Legal Business Name): REBECCA CHALFANT DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BECCA CHALFANT DNP

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HIGH PARK AVE
GOSHEN IN
46526-4810
US

IV. Provider business mailing address

6256 BEHNER WAY
INDIANAPOLIS IN
46250-1494
US

V. Phone/Fax

Practice location:
  • Phone: 574-364-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number28248243A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: