Healthcare Provider Details

I. General information

NPI: 1700507563
Provider Name (Legal Business Name): CONSTANCE CHATTERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3835 NORTHERN PIKE STE 1
MONROEVILLE PA
15146-2132
US

IV. Provider business mailing address

PO BOX 1200
PLEASANT GROVE UT
84062-1200
US

V. Phone/Fax

Practice location:
  • Phone: 800-640-3451
  • Fax:
Mailing address:
  • Phone: 800-640-3451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP036054
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024191471
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11018072
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: