Provider Demographics
NPI:1821331711
Name:CHAFFIN, DANA R (APRN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:R
Last Name:CHAFFIN
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7285 HIGHWAY 16, SUITE C
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276
Mailing Address - Country:US
Mailing Address - Phone:770-599-0505
Mailing Address - Fax:770-599-3413
Practice Address - Street 1:7285 HIGHWAY 16, SUITE C
Practice Address - Street 2:
Practice Address - City:SENOIA
Practice Address - State:GA
Practice Address - Zip Code:30276
Practice Address - Country:US
Practice Address - Phone:770-599-0505
Practice Address - Fax:770-599-3413
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN208967363L00000X
GA42585207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner