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Individual
MR. TODD L CHIDESTER
Active
Individual
MR. TODD L CHIDESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
195992-8900
UT
363LP0200X
Pediatric Nurse Practitioner
Primary
195992-4405
UT
Other
Enumeration date
04/04/2006
Last updated
01/19/2011
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