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General NPI Number Information
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NPI Number | 1447905179
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Entity Type | Individual
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Provider Name | SUZANNE M CHESTNUT APRN
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Gender | Female
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Dates
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Enumeration Date | 02/22/2022
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 10898 BAYMEADOWS RD STE 300
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City | JACKSONVILLE
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State | FL
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Zip | 32256-5838
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Country | US
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Telephone | 904-363-2733
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Fax | 904-390-7484
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Provider Business Mailing Address
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Address Line | PO BOX 746638
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City | ATLANTA
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State | GA
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Zip | 30374-6638
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Country | US
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Telephone | 904-202-2092
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Fax | 904-376-4075
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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 | APRN11016862
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License Number State | FL
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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 | APRN11016862
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11016862
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License Number State | FL
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