Individual
LINDA CHESLEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
807 MONROE ST, VICKSBURG, MS 39183-2529
(601) 636-4356
Mailing address
807 MONROE ST, VICKSBURG, MS 39183-2529
(601) 636-4356
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R526894
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014396
—
MS
Enumeration date
02/20/2007
Last updated
07/09/2007
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