MEDICARE: CHELSI VANPATTEN

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	225X00000X	Occupational Therapist	2053	NH

General Provider Information

NPI Number	:	1629494950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSI VANPATTEN

Provider Business Mailing Address
First Line	:	PO BOX 486
Second Line	:
City	:	BUENA VISTA
State	:	CO
Zip	:	81211-0486
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 ISABEL CT
Second Line	:
City	:	BUENA VISTA
State	:	CO
Zip	:	81211-9551
Country	:	US
Telephone Number	:	719-395-8711
Fax Number	:	719-395-9062

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

Provider Enumeration Date	:	03/11/2014
Last Update Date	:	03/11/2014

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Directions to “ CHELSI VANPATTEN ” Practice Location

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