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General NPI Number Information
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NPI Number | 1083944185
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Entity Type | Individual
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Provider Name | MICHAEL JASON CHASTANT ACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 1000 S BECKHAM AVE
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City | TYLER
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State | TX
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Zip | 75701-1908
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Country | US
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Telephone | 903-590-5611
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Fax | 903-535-6884
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Provider Business Mailing Address
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Address Line | 1000 S BECKHAM AVE
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City | TYLER
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State | TX
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Zip | 75701-1908
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Country | US
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Telephone | 903-590-5611
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Fax | 903-535-6884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 713739
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 713739
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 713739
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License Number State | TX
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