Individual
DR. LISA RENEE CHASTANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 ST LUKES BLVD STE 102, EASTON, PA 18045-5671
(484) 503-7546
(484) 503-7547
Mailing address
419 RUSSELL AVE, OCEAN SPRINGS, MS 39564-4727
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
19930
ND
207N00000X
Dermatology Physician
26245
MS
207N00000X
Dermatology Physician
3284-20
WI
207ND0101X
MOHS-Micrographic Surgery Physician
26245
MS
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD488857C
PA
2083A0100X
Aerospace Medicine Physician
C1-0009800
DE
208D00000X
General Practice Physician
C1-0009800
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144545195
—
WI
Enumeration date
04/01/2010
Last updated
09/15/2025
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