Provider Demographics
NPI:1538661277
Name:CHAUSSINAND, MARY FRANCES (CPNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:CHAUSSINAND
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12020 ETRIS RD STE B140
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-8013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12020 ETRIS RD STE B140
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-8013
Practice Address - Country:US
Practice Address - Phone:770-691-9000
Practice Address - Fax:404-777-0938
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN262302NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics