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Individual

SCOTT J CHASTEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA / ARNP

Contact information

Practice address
709 W MAIN ST, MANCHESTER, IA 52057-1526
(563) 822-1435
(563) 822-1435
Mailing address
712 W MAIN ST, MANCHESTER, IA 52057-1525
(563) 822-1435
(536) 822-1436

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
D126589
IA
367500000X
Certified Registered Nurse Anesthetist
076713
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
D126589
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
901662000
MN
01
918N4CH
BLUE CROSS BLUE SHIELD
MN
Enumeration date
01/03/2007
Last updated
04/20/2023
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