Provider Demographics
NPI:1689980864
Name:CHESMAR, DEBORAH (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:CHESMAR
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 16TH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-5117
Mailing Address - Country:US
Mailing Address - Phone:720-903-0761
Mailing Address - Fax:
Practice Address - Street 1:4361 LATHAM ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-1730
Practice Address - Country:US
Practice Address - Phone:720-672-3261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007879363LA2200X
CA95014207363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA476859OtherMEDICARE