Provider Demographics
NPI:1669862850
Name:CHRISTEAN, CHESARAE
Entity Type:Individual
Prefix:
First Name:CHESARAE
Middle Name:
Last Name:CHRISTEAN
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 1:2105 CAPURRO WAY
Mailing Address - Street 2:SUITE260
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-8518
Mailing Address - Country:US
Mailing Address - Phone:775-378-2775
Mailing Address - Fax:775-622-3979
Practice Address - Street 1:2105 CAPURRO WAY
Practice Address - Street 2:SUITE260
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-8518
Practice Address - Country:US
Practice Address - Phone:775-378-2775
Practice Address - Fax:775-622-3979
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner