Healthcare Provider Details

I. General information

NPI: 1114547528
Provider Name (Legal Business Name): CHELSEA N. BRIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2020
Last Update Date: 12/09/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2907 S ORLANDO ST
PINE BLUFF AR
71603-4752
US

IV. Provider business mailing address

2907 S ORLANDO ST
PINE BLUFF AR
71603-4752
US

V. Phone/Fax

Practice location:
  • Phone: 870-945-2250
  • Fax:
Mailing address:
  • Phone: 870-945-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: