Provider Demographics
NPI:1043765431
Name:AUGUSTIN, BIMISA CHATA (DNP, MSN, APRN,FNP-C)
Entity type:Individual
Prefix:DR
First Name:BIMISA
Middle Name:CHATA
Last Name:AUGUSTIN
Suffix:
Gender:
Credentials:DNP, MSN, APRN,FNP-C
Other - Prefix:MRS
Other - First Name:BIMISA
Other - Middle Name:CHATA
Other - Last Name:RENTERIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-C
Mailing Address - Street 1:3604 DODGE CITY DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-5728
Mailing Address - Country:US
Mailing Address - Phone:949-484-9517
Mailing Address - Fax:361-371-7090
Practice Address - Street 1:2719 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3354
Practice Address - Country:US
Practice Address - Phone:737-377-1600
Practice Address - Fax:949-569-1295
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM72601363LF0000X
NC854621363LF0000X
KY4015467363LF0000X
TN34323363LF0000X
COC-APN.0002449-C-NP363LF0000X
OHAPRN.CNP.0032880363LF0000X
AZ267933363LF0000X
CA95028143363LF0000X
FLAPRN11025601363LF0000X
NVMA7445643363LF0000X
MI4704418733363LF0000X
NH112050-23363LF0000X
MECNP241343363LF0000X
TXAP131920363LF0000X
OK208982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily