Provider Demographics
NPI:1518232347
Name:CHESNEY, MAURA BETH (RD, LDN)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:BETH
Last Name:CHESNEY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 5TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4228
Mailing Address - Country:US
Mailing Address - Phone:717-364-0369
Mailing Address - Fax:
Practice Address - Street 1:765 5TH AVE STE A
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4228
Practice Address - Country:US
Practice Address - Phone:717-364-0369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003817133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3482223OtherHIGHMARK BLUE SHIELD