Provider Demographics
NPI:1699371641
Name:OSTRANDER, CHASSITY MICHELLE
Entity type:Individual
Prefix:
First Name:CHASSITY
Middle Name:MICHELLE
Last Name:OSTRANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 GIBSON LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2577
Mailing Address - Country:US
Mailing Address - Phone:859-661-4526
Mailing Address - Fax:859-623-9160
Practice Address - Street 1:415 GIBSON LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2577
Practice Address - Country:US
Practice Address - Phone:859-661-4526
Practice Address - Fax:859-623-9160
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2039342164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse