Provider Demographics
NPI:1942081609
Name:DOBSON, CHYADE (MSN, ARNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CHYADE
Middle Name:
Last Name:DOBSON
Suffix:
Gender:F
Credentials:MSN, ARNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 BISCAYNE GROVE LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8678
Mailing Address - Country:US
Mailing Address - Phone:904-525-4566
Mailing Address - Fax:
Practice Address - Street 1:2015 GRANT PL
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5600
Practice Address - Country:US
Practice Address - Phone:772-492-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2023129894363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health