MEDICARE: MR. CHESTER CARL BOSTEK CRNA, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	533	AK
2	367500000X	Certified Registered Nurse Anesthetist	141	AK
3	367500000X	Certified Registered Nurse Anesthetist	755	HI
4	367500000X	Certified Registered Nurse Anesthetist	AP30006355	WA
5	367500000X	Certified Registered Nurse Anesthetist	1966	CA
6	367500000X	Certified Registered Nurse Anesthetist	5191A	KY
7	367500000X	Certified Registered Nurse Anesthetist	NP0091	GU

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00719442	OTHER	AK	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000521897	OTHER	KY	BLUECROSS/BLUESHIELD KY
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000521897	OTHER	KY	ANTHEM BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770588543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHESTER CARL BOSTEK CRNA, FNP

Provider Business Mailing Address
First Line	:	221 E 7TH AVE APT 115
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501-3639
Country	:	US
Telephone Number	:	907-317-6470
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 E 7TH AVE APT 115
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501-3639
Country	:	US
Telephone Number	:	907-317-6470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/06/2009

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