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General NPI Number Information
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NPI Number | 1841476363
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Entity Type | Individual
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Provider Name | GENEVA CHASTANET-SEVERIN APRN
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Gender | Female
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Dates
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Enumeration Date | 01/15/2008
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 5901 CHASE RD STE 210
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City | DEARBORN
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State | MI
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Zip | 48126-0900
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Country | US
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Telephone | 832-869-4818
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Fax | 832-241-2902
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Provider Business Mailing Address
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Address Line | 1425 STARR AVE
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City | TOLEDO
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State | OH
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Zip | 43605-2456
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Country | US
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Telephone | 419-693-0631
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN 298606
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.022197
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704302911
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License Number State | MI
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