Individual
MS. PHYLLIS J CHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1600 NORTH MAIN, LOVINGTON, NM 88260-2830
(575) 396-6611
(575) 396-1454
Mailing address
1600 NORTH MAIN, LOVINGTON, NM 88260-2830
(575) 396-6611
(575) 396-1454
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-83664
NM
363L00000X
Nurse Practitioner
0024113734
VA
363L00000X
Nurse Practitioner
Primary
CNP-02905
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007780184
—
VA
01
—
1518925007
PALMETTO
VA
01
—
486152YNGG
PTAN
NM
01
—
500007207
PALMETTO RAILROAD
VA
05
—
61808563
—
NM
Enumeration date
05/03/2006
Last updated
08/17/2017
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