Provider Demographics
NPI:1922728807
Name:GATTON, CHAYNNA
Entity Type:Individual
Prefix:
First Name:CHAYNNA
Middle Name:
Last Name:GATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MULESHOE TRL
Mailing Address - Street 2:
Mailing Address - City:ELKLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65644-7220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 MULESHOE TRL
Practice Address - Street 2:
Practice Address - City:ELKLAND
Practice Address - State:MO
Practice Address - Zip Code:65644-7220
Practice Address - Country:US
Practice Address - Phone:417-298-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017020458163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse