MEDICARE: CHELSEA NOELLE WARNER PHYSICIAN ASSISTANT

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1720677891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA NOELLE WARNER PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	1 CONVENTION AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4311
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 SOUTH STREET
Second Line	:	APT 3
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146
Country	:	US
Telephone Number	:	978-793-2875
Fax Number	:

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

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	10/26/2024

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