Provider Demographics
NPI:1447786371
Name:CHESTER, MENIA
Entity Type:Individual
Prefix:
First Name:MENIA
Middle Name:
Last Name:CHESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3539 APALACHEE PKWY STE 3
Mailing Address - Street 2:#58
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-5329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3539 APALACHEE PKWY STE 3
Practice Address - Street 2:#58
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-5329
Practice Address - Country:US
Practice Address - Phone:850-692-9072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No174H00000XOther Service ProvidersHealth Educator