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General NPI Number Information
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NPI Number | 1881486504
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Entity Type | Individual
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Provider Name | CALLIE CHESTER FNP
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Gender |
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 112 BANKS RD STE 1
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City | COMMERCE
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State | GA
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Zip | 30529-6300
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Country | US
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Telephone | 706-677-4568
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Fax |
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Provider Business Mailing Address
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Address Line | 3865 ALEXANDRIA DR
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City | GAINESVILLE
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State | GA
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Zip | 30506-4318
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Country | US
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Telephone | 410-991-6172
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN302612
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN302612
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License Number State | GA
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