Provider Demographics
NPI:1003205857
Name:HEATH, CHASTITY H (NP)
Entity Type:Individual
Prefix:MS
First Name:CHASTITY
Middle Name:H
Last Name:HEATH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHASTITY
Other - Middle Name:N
Other - Last Name:HOLLISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:8060 WOLF RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1727
Mailing Address - Country:US
Mailing Address - Phone:901-271-1000
Mailing Address - Fax:901-271-4187
Practice Address - Street 1:100 BAPTIST MEMORIAL CIR STE 201
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4476
Practice Address - Country:US
Practice Address - Phone:901-271-1000
Practice Address - Fax:901-516-5370
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR8678282163W00000X
TN19573363LF0000X
MSR867282363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse