Healthcare Provider Details

I. General information

NPI: 1689537995
Provider Name (Legal Business Name): JASMINE CHIE CHATMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6011 GROVEPORT RD
GROVEPORT OH
43125-1006
US

IV. Provider business mailing address

105 MOORE CT
PICKERINGTON OH
43147-2250
US

V. Phone/Fax

Practice location:
  • Phone: 614-343-4783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0040036
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: