Provider Demographics
NPI:1770588543
Name:BOSTEK, CHESTER CARL (CRNA, FNP)
Entity type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:CARL
Last Name:BOSTEK
Suffix:
Gender:M
Credentials:CRNA, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E 7TH AVE APT 115
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3639
Mailing Address - Country:US
Mailing Address - Phone:907-317-6470
Mailing Address - Fax:
Practice Address - Street 1:221 E 7TH AVE APT 115
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3639
Practice Address - Country:US
Practice Address - Phone:907-317-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK533363LF0000X
AK141367500000X
HI755367500000X
WAAP30006355367500000X
CA1966367500000X
KY5191A367500000X
GUNP0091367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKP00719442OtherRAILROAD MEDICARE
AKRNA0002Medicaid
KY000000521897OtherBLUECROSS/BLUESHIELD KY
KY7100022940Medicaid
KY000000521897OtherANTHEM BCBS
AKNP1208Medicaid
KY7100022940Medicaid
AKNP1208Medicaid
H56946Medicare PIN
KY000000521897OtherBLUECROSS/BLUESHIELD KY