Provider Demographics
NPI:1144983115
Name:CHESNEY, SIERRA RICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:RICHELLE
Last Name:CHESNEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 THE BARRENS RD
Mailing Address - Street 2:
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-9812
Mailing Address - Country:US
Mailing Address - Phone:814-505-8373
Mailing Address - Fax:
Practice Address - Street 1:1 TECH PARK DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-2515
Practice Address - Country:US
Practice Address - Phone:814-475-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA062560363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant