Provider Demographics
NPI:1225303886
Name:CHESSOR, MISTY LYNN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:LYNN
Last Name:CHESSOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:MISTY
Other - Middle Name:LYNN
Other - Last Name:HUGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:508 E MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-3403
Mailing Address - Country:US
Mailing Address - Phone:706-272-1645
Mailing Address - Fax:
Practice Address - Street 1:508 E MORRIS ST
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-3403
Practice Address - Country:US
Practice Address - Phone:706-272-1645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN225780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily