La'Tisha Shenay Chastang, BA

Individual provider Active NPI Case Manager/Care Coordinator · Gautier, MS

NPI 1043446552 · NPPES record last updated Jun 10, 2009

Key facts

NPI
1043446552
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
3407 Shamrock CT
Gautier, MS 39553-6429
Phone
(228) 497-0690
Fax
(228) 497-1363
NPI assigned
Jun 10, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

3407 Shamrock CT
Gautier, MS 39553-6429

Mailing address

3407 Shamrock CT
Gautier, MS 39553-6429
Phone (228) 497-0690

Other identifiers

IdentifierTypeStateIssuer
00018214MedicaidMS

Other providers in Gautier, MS

All providers in Gautier, MS · Case Manager/Care Coordinator in Mississippi

Sources for this page

Verify at the official NPI Registry.