Provider Demographics
NPI:1710595459
Name:CHESTNUT, ARTRAMETACHE (LPN)
Entity Type:Individual
Prefix:MS
First Name:ARTRAMETACHE
Middle Name:
Last Name:CHESTNUT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:ARTRAMETA
Other - Middle Name:
Other - Last Name:O'KELLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:2525 KOLB MANOR CIR SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-5990
Mailing Address - Country:US
Mailing Address - Phone:678-851-7033
Mailing Address - Fax:
Practice Address - Street 1:2525 KOLB MANOR CIR SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-5990
Practice Address - Country:US
Practice Address - Phone:678-851-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN055335251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health