Provider Demographics
NPI:1548939127
Name:CHESNA, AMY J
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:CHESNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4835 HOPEWELL MANOR DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-4035
Mailing Address - Country:US
Mailing Address - Phone:678-314-5523
Mailing Address - Fax:
Practice Address - Street 1:4835 HOPEWELL MANOR DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30028-4035
Practice Address - Country:US
Practice Address - Phone:678-314-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN053160164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse