Provider Demographics
NPI:1659372761
Name:CHASTAIN, JANET (NNP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:CHASTAIN
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE B 420
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5382
Mailing Address - Country:US
Mailing Address - Phone:404-252-9751
Mailing Address - Fax:678-990-5763
Practice Address - Street 1:5901 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE B 420
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5382
Practice Address - Country:US
Practice Address - Phone:404-252-9751
Practice Address - Fax:678-990-5763
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN044384363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000934865EMedicaid
GA000934865DMedicaid
GA000934865BMedicaid