MEDICARE: RACHELL CHESMORE

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	163W00000X	Registered Nurse	1141333030	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164487849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELL CHESMORE

Provider Business Mailing Address
First Line	:	3840 MALLARD LN
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53546-4383
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9404 N KLUG RD
Second Line	:
City	:	MILTON
State	:	WI
Zip	:	53563-9322
Country	:	US
Telephone Number	:	608-868-1691
Fax Number	:

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	07/08/2007

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Directions to “ RACHELL CHESMORE ” Practice Location

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