Provider Demographics
NPI:1932625787
Name:CRIST, CHASIDY RENEE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHASIDY
Middle Name:RENEE
Last Name:CRIST
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 COUNTY ROAD 165
Mailing Address - Street 2:
Mailing Address - City:ASHLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43003-9761
Mailing Address - Country:US
Mailing Address - Phone:740-272-2573
Mailing Address - Fax:
Practice Address - Street 1:1000 MCKINLEY PARK DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6399
Practice Address - Country:US
Practice Address - Phone:740-383-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily