Provider Demographics
NPI:1356040117
Name:O'QUINN, CHASTITY M (RD)
Entity type:Individual
Prefix:
First Name:CHASTITY
Middle Name:M
Last Name:O'QUINN
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:CHASTITY
Other - Middle Name:MARIE
Other - Last Name:O'QUINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 632476
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2476
Mailing Address - Country:US
Mailing Address - Phone:423-230-2500
Mailing Address - Fax:423-239-7502
Practice Address - Street 1:444 CLINCHFIELD ST STE 2500
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3858
Practice Address - Country:US
Practice Address - Phone:423-230-2500
Practice Address - Fax:423-239-7502
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4537133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered