Provider Demographics
NPI:1689122608
Name:CLOUD TAULTON, CHASITY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHASITY
Middle Name:
Last Name:CLOUD TAULTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5923 AMHERST CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8942
Mailing Address - Country:US
Mailing Address - Phone:832-573-2580
Mailing Address - Fax:
Practice Address - Street 1:5923 AMHERST CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8942
Practice Address - Country:US
Practice Address - Phone:832-573-2580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131768363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily