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Individual

MRS. DEONN MICHELLE CHESTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, RN, FNP-BC

Contact information

Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4917
(765) 502-4023
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28163944A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007394A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
28163944A
RN LICENSE
IN
01
71007394A
APN LICENSE
IN
Enumeration date
08/24/2017
Last updated
01/03/2023
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