Healthcare Provider Details

I. General information

NPI: 1568539013
Provider Name (Legal Business Name): JEANNE MARIE CHATTAWAY PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 ARMSTRONG RD
BATTLE CREEK MI
49015-1014
US

IV. Provider business mailing address

5029 COOPERS LANDING DR APT #14
KALAMAZOO MI
49004-6608
US

V. Phone/Fax

Practice location:
  • Phone: 269-966-5600
  • Fax: 269-223-5669
Mailing address:
  • Phone: 517-256-9994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5302034152
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: