Kellie Derae Chestnut in Jacksonville - Developmental Therapist
Kellie Derae Chestnut - NPI 1902990328
Kellie Derae Chestnut is a Developmental Therapist in Jacksonville, Florida. Kellie Derae Chestnut practices all healthcare services and medical treatments related to Developmental Therapist. The NPI Number for Kellie Derae Chestnut is 1902990328. The last update date is 2019-03-13.
Kellie Derae Chestnut's current location address is 910 N Jefferson St, Jacksonville, Florida. You can contact this provider via phone number 2708475723. The mailing address for Kellie Derae Chestnut is 910 N Jefferson St, Jacksonville, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kellie Derae Chestnut |
|---|---|
| Address | 910 N Jefferson St, Jacksonville, Florida |
| Phone Number | 2708475723 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | ITDS, M.A. |
NPI Number Detail
| NPI Number | 1902990328 |
|---|---|
| Provider Enumeration Date | 2006-10-02 |
| Last Updated Date | 2019-03-13 |
Provider Mailing Address Detail
| Address | 910 N Jefferson St |
|---|---|
| City | Jacksonville |
| State | Florida (FL) |
| Post Code | 322096810 |
| Phone Number | 2708475723 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Developmental Therapist |
|---|---|
| Taxonomy | 222Q00000X |
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Definition: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education |
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Post Comment/ Review Below
What is the Kellie Derae Chestnut's unique identification number?
The Kellie Derae Chestnut has been assigned the NPI (National Provider Identifier) Number 1902990328 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Kellie Derae Chestnut is geographically located?
The Kellie Derae Chestnut is physically situated at the following location: 910 N Jefferson St, Jacksonville, FL, 322096810.
What is Kellie Derae Chestnut's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Kellie Derae Chestnut is Developmental Therapist, and the corresponding taxonomy classification code for this specialized field is 222Q00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1902990328 to Kellie Derae Chestnut?
The Kellie Derae Chestnut received its 1902990328 assignment from the Centers for Medicare & Medicaid Services on 2006-10-02.
As of what date were the details related to Kellie Derae Chestnut most recently updated or revised?
The information pertaining to Kellie Derae Chestnut, including its address, specialty, and other relevant details, was last updated or revised on 2019-03-13.