Provider Demographics
NPI:1689749376
Name:CHESSHIR, NATHAN DOUGLAS (CRNA)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:DOUGLAS
Last Name:CHESSHIR
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:DOUG
Other - Middle Name:
Other - Last Name:CHESSHIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:1808
Mailing Address - Street 2:MUIRFIELD DR.
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:66520
Mailing Address - Country:US
Mailing Address - Phone:573-443-6737
Mailing Address - Fax:573-815-2308
Practice Address - Street 1:305 N KEENE ST STE 107
Practice Address - Street 2:BOONE SURGERY CENTER
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6897
Practice Address - Country:US
Practice Address - Phone:636-386-9224
Practice Address - Fax:636-386-7679
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO088585367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered