Individual
LORRAINE CHIDESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP
Contact information
Practice address
5408 NW 88TH ST STE 140, JOHNSTON, IA 50131-2953
(515) 368-7504
Mailing address
5408 NW 88TH ST STE 140, JOHNSTON, IA 50131-2953
(515) 368-7504
(515) 355-3491
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G155077
IA
Other
Enumeration date
02/14/2019
Last updated
10/04/2022
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