Provider Demographics
NPI:1851109169
Name:CHESTER, GABRIEL RYAN (EMT-B)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:RYAN
Last Name:CHESTER
Suffix:
Gender:M
Credentials:EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N KNOLLWOOD DR STE 6103
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6379
Mailing Address - Country:US
Mailing Address - Phone:757-633-5729
Mailing Address - Fax:
Practice Address - Street 1:303 N KNOLLWOOD DR
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6379
Practice Address - Country:US
Practice Address - Phone:757-633-5729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB202102435146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic