Healthcare Provider Details

I. General information

NPI: 1053979708
Provider Name (Legal Business Name): CHELSEY NICOLE KAHLER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7191 CAHABA VALLEY RD STE 300
BIRMINGHAM AL
35242-6461
US

IV. Provider business mailing address

7191 CAHABA VALLEY RD STE 300
BIRMINGHAM AL
35242-6461
US

V. Phone/Fax

Practice location:
  • Phone: 205-995-9909
  • Fax: 205-930-2063
Mailing address:
  • Phone: 205-995-9909
  • Fax: 205-930-2063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-143276
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-143276
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-143276
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-143276
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: