Healthcare Provider Details

I. General information

NPI: 1871418525
Provider Name (Legal Business Name): ANN-MARIE CHESTRESS NELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 E STATE ST
CHEBOYGAN MI
49721-2124
US

IV. Provider business mailing address

6444 MANNING RD
CHEBOYGAN MI
49721-9593
US

V. Phone/Fax

Practice location:
  • Phone: 231-268-0360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberN425067115964
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: