Provider Demographics
NPI:1992214068
Name:CESAR, CHANTAL (APRN AGNP-C)
Entity Type:Individual
Prefix:
First Name:CHANTAL
Middle Name:
Last Name:CESAR
Suffix:
Gender:F
Credentials:APRN AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 BAKER PLANTATION WAY
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-6218
Mailing Address - Country:US
Mailing Address - Phone:678-717-9339
Mailing Address - Fax:
Practice Address - Street 1:4921 BAKER PLANTATION WAY
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-6218
Practice Address - Country:US
Practice Address - Phone:678-717-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN174812363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology