Provider Demographics
NPI:1457782369
Name:CHESNEY, LYNNA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:LYNNA
Middle Name:LYNN
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 1:323 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16662-1315
Mailing Address - Country:US
Mailing Address - Phone:814-793-3514
Mailing Address - Fax:
Practice Address - Street 1:1741 DUAL HWY
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6624
Practice Address - Country:US
Practice Address - Phone:301-790-0254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05281363A00000X
PAMA056655363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant