Provider Demographics
NPI:1679256655
Name:CHAFIN, JUSTIN WAYNE (CRNA)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:WAYNE
Last Name:CHAFIN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SCHENCK PKWY
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-5053
Mailing Address - Country:US
Mailing Address - Phone:304-208-4370
Mailing Address - Fax:
Practice Address - Street 1:3475 BLAZER PKWY STE 130
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1850
Practice Address - Country:US
Practice Address - Phone:859-514-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4025219367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered