Polly Lou Chesser, RN

Individual provider Active NPI Registered Nurse · Manitou Beach, MI

NPI 1447096474 · NPPES record last updated Jul 9, 2024

Key facts

NPI
1447096474
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
4704202125 (MI)
Practice address
13149 US Highway 223
Manitou Beach, MI 49253-9521
Phone
(517) 442-9506
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704202125MIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704202125 MI Yes

Addresses

Primary practice location

13149 US Highway 223
Manitou Beach, MI 49253-9521

Mailing address

13149 US Highway 223
Manitou Beach, MI 49253-9521
Phone (517) 442-9506

Other providers in Manitou Beach, MI

All providers in Manitou Beach, MI · Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.