Chestnut, Kellie Derae

Chestnut, Kellie Derae is an sole proprietor health care provider with primary practice located at 910 N Jefferson St , Jacksonville FL 32209-6810. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Other Service Providers / Case Manager/Care Coordinator. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist is her primary health care specialty. Chestnut, Kellie Derae can be contacted via phone (270) 847-5723.

Contact Information

Primary practice address
910 N Jefferson St Jacksonville FL 32209-6810
Phone: (270) 847-5723
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1902990328
LBN Legal business name Chestnut, Kellie Derae
Credentials ITDS, M.A.E.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Mar 13th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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