Provider Demographics
NPI:1821550823
Name:CHESSER, CHERYL MARIE
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:MARIE
Last Name:CHESSER
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 1:3113 PRIMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-1630
Mailing Address - Country:US
Mailing Address - Phone:504-881-6007
Mailing Address - Fax:
Practice Address - Street 1:2151 9TH ST
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-6774
Practice Address - Country:US
Practice Address - Phone:504-466-4940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL593000726224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist