Provider Demographics
NPI:1487225280
Name:CHASTEEN, HEATHER L (APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:CHASTEEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 MAHAN CENTER BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5476
Mailing Address - Country:US
Mailing Address - Phone:850-999-2996
Mailing Address - Fax:850-536-6439
Practice Address - Street 1:1618 MAHAN CENTER BLVD STE 103
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5476
Practice Address - Country:US
Practice Address - Phone:850-999-2996
Practice Address - Fax:850-536-6439
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013531363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health