Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Kellie Derae Chestnut, ITDS, MAE

Individual provider Developmental Therapist · NPI 1902990328

MS. Kellie Derae Chestnut, ITDS, MAE is a Developmental Therapist in Jacksonville, Florida. Practices as a sole proprietor. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
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Practice location Address checks out

910 N Jefferson St
Jacksonville, FL 32209-6810
Phone: (270) 847-5723
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Specialties & licences

Developmental Therapist (primary) Taxonomy 222Q00000X
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1902990328
Entity typeIndividual (Type 1)
GenderFemale
Credentials ITDS , MAE
Sole proprietorYes
NPI enumeratedOctober 2, 2006
Last updated in NPPESMarch 13, 2019
Mailing address910 N Jefferson St, Jacksonville, FL 32209-6810

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