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General NPI Number Information
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NPI Number | 1558048777
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Entity Type | Individual
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Provider Name | AMY LYNN CHAFFIN APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 2927 DEMERE RD
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City | SAINT SIMONS ISLAND
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State | GA
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Zip | 31522-1620
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Country | US
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Telephone | 912-638-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 320 PALM CLUB CIR
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City | BRUNSWICK
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State | GA
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Zip | 31525-2051
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Country | US
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Telephone | 740-703-2313
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN298928
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License Number State | GA
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