Provider Demographics
NPI:1770701807
Name:CHESLEY, MEGAN S (CRNA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:S
Last Name:CHESLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 E MAIN ST
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-1888
Mailing Address - Country:US
Mailing Address - Phone:641-752-7149
Mailing Address - Fax:641-752-6320
Practice Address - Street 1:312 E MAIN ST
Practice Address - Street 2:SUITE 2300
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-1888
Practice Address - Country:US
Practice Address - Phone:641-752-7149
Practice Address - Fax:641-752-6320
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA104046163W00000X
IAD-104046367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1770701807Medicaid
IA04566OtherWBCBS OF IOWA
IAI20143Medicare PIN