Provider Demographics
NPI:1083704407
Name:CHESTER, JUNE P (RN, BSN, CRNFA)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:P
Last Name:CHESTER
Suffix:
Gender:F
Credentials:RN, BSN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 PITTS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-2327
Mailing Address - Country:US
Mailing Address - Phone:478-986-6825
Mailing Address - Fax:478-986-6825
Practice Address - Street 1:827 PITTS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-2327
Practice Address - Country:US
Practice Address - Phone:478-986-6825
Practice Address - Fax:478-986-6825
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN039858163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52268332OtherBLUE CROSS/BLUE SHIELD