MEDICARE: ELAINE CHESTER

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1043681323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE CHESTER

Provider Business Mailing Address
First Line	:	601 S. RANCHO
Second Line	:	A10
City	:	LAS VEGAS
State	:	NV
Zip	:	89106
Country	:	US
Telephone Number	:	702-437-4673
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 S RANCHO DR STE A10
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4898
Country	:	US
Telephone Number	:	24-374-6737
Fax Number	:

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

Provider Enumeration Date	:	10/13/2015
Last Update Date	:	03/30/2020

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Directions to “ ELAINE CHESTER ” Practice Location

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