Provider Demographics
NPI:1720555741
Name:CHINTU, CHARLOTTE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:CHINTU
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:GA
Mailing Address - Zip Code:31545-0210
Mailing Address - Country:US
Mailing Address - Phone:404-384-5237
Mailing Address - Fax:
Practice Address - Street 1:221 TENNIS COURT LN NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-5028
Practice Address - Country:US
Practice Address - Phone:404-384-5237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA232906363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily