Provider Demographics
NPI:1841265972
Name:PESTER, CHANDRA L (RN CNS)
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:L
Last Name:PESTER
Suffix:
Gender:F
Credentials:RN CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 5021
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:513-636-5013
Mailing Address - Fax:866-213-7084
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 4002
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-636-5013
Practice Address - Fax:866-213-7084
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.04343-NS364SP0807X
OHRX04343163W00000X
OHCOA04343-NS364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist