Individual
KATHLEEN ELAINE CHASTEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19500 SANDRIDGE WAY, SUITE 420, LEESBURG, VA 20176
(571) 375-8601
Mailing address
20116 ASHBROOK PL STE 150, ASHBURN, VA 20147-5087
(703) 385-5203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487304762
—
VA
05
—
30017448960002
—
VA
Enumeration date
03/28/2022
Last updated
07/12/2024
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