Provider Demographics
NPI:1063093755
Name:CHESTERMAN, JASON (BSN, RN, CRRN)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:CHESTERMAN
Suffix:
Gender:M
Credentials:BSN, RN, CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4116
Mailing Address - Country:US
Mailing Address - Phone:973-704-6867
Mailing Address - Fax:
Practice Address - Street 1:55 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4116
Practice Address - Country:US
Practice Address - Phone:973-704-6867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR18495000163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health