MEDICARE: CHELSEA GIESEN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse	95185559	CA

General Provider Information

NPI Number	:	1255916177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA GIESEN RN

Provider Business Mailing Address
First Line	:	2553 CHICAGO ST APT 20
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4193
Country	:	US
Telephone Number	:	949-812-1595
Fax Number	:

Provider Business Practice Location Address
First Line	:	2553 CHICAGO ST APT 20
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4193
Country	:	US
Telephone Number	:	949-812-1595
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2021
Last Update Date	:	03/11/2021

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