MEDICARE: DANEEKA A. CHASTANG NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN 104691	LA
2	363L00000X	Nurse Practitioner	AP06073	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295050953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANEEKA A. CHASTANG NP

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	225-605-0534
Fax Number	:	877-269-9924

Provider Business Practice Location Address
First Line	:	17123 COMMERCE CENTRE DR
Second Line	:
City	:	PRAIRIEVILLE
State	:	LA
Zip	:	70769-3481
Country	:	US
Telephone Number	:	225-605-0534
Fax Number	:	877-269-9924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	01/13/2026

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