Provider Demographics
NPI:1073830865
Name:CHATMAN, ANASTACIA CLARICE (LPN)
Entity Type:Individual
Prefix:
First Name:ANASTACIA
Middle Name:CLARICE
Last Name:CHATMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14707 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8965
Mailing Address - Country:US
Mailing Address - Phone:303-375-9250
Mailing Address - Fax:
Practice Address - Street 1:14707 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8965
Practice Address - Country:US
Practice Address - Phone:303-375-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44352164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse