Provider Demographics
NPI:1073098620
Name:CHESTNUT, JANICE CARINO (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:CARINO
Last Name:CHESTNUT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 BROOKS ST
Mailing Address - Street 2:
Mailing Address - City:SULLIVANS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29482-9673
Mailing Address - Country:US
Mailing Address - Phone:843-345-0906
Mailing Address - Fax:
Practice Address - Street 1:2195 TEA PLANTER LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7804
Practice Address - Country:US
Practice Address - Phone:843-881-2583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-29
Last Update Date:2018-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist