=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295050953
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANEEKA A. CHASTANG NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2010
-----------------------------------------------------
Last Update Date | 01/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17123 COMMERCE CENTRE DR
-----------------------------------------------------
City | PRAIRIEVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70769-3481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-605-0534
-----------------------------------------------------
Fax | 877-269-9924
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6101 BLUE LAGOON DR STE 200
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33126-3168
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-605-0534
-----------------------------------------------------
Fax | 877-269-9924
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | RN 104691
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | AP06073
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------