Provider Demographics
NPI:1407725278
Name:CHASKE, JERAH
Entity type:Individual
Prefix:
First Name:JERAH
Middle Name:
Last Name:CHASKE
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 1:418 5TH ST NE APT 301
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-2564
Mailing Address - Country:US
Mailing Address - Phone:701-350-7487
Mailing Address - Fax:
Practice Address - Street 1:418 5TH ST NE APT 301
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-2564
Practice Address - Country:US
Practice Address - Phone:701-350-7487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-31
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty