Provider Demographics
NPI:1427253368
Name:CHATSON, ALESSANDRA (DNP)
Entity type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:CHATSON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W PATERSON ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-2581
Mailing Address - Country:US
Mailing Address - Phone:269-349-2641
Mailing Address - Fax:269-466-5522
Practice Address - Street 1:117 W PATERSON ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-2581
Practice Address - Country:US
Practice Address - Phone:269-349-2641
Practice Address - Fax:269-466-5522
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002732363L00000X
MI4704275303363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1427253368OtherBC/BS
IN200942210Medicaid
IN259950IMedicare PIN
MIM81880012Medicare PIN