Provider Demographics
NPI:1053084186
Name:DECAIRES-CHESTER, NATASHA CHINAKESHA (NP)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:CHINAKESHA
Last Name:DECAIRES-CHESTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9163 BEECHDALE CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-7019
Mailing Address - Country:US
Mailing Address - Phone:301-395-1869
Mailing Address - Fax:
Practice Address - Street 1:5 GARRETT AVE
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-5960
Practice Address - Country:US
Practice Address - Phone:301-609-4287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205123363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology