Healthcare Provider Details

I. General information

NPI: 1801504915
Provider Name (Legal Business Name): CHELSEA M BOSTELMAN AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHELSEA M GERKEN

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

IV. Provider business mailing address

754 DAFFODIL ST
FOUNTAIN CO
80817-4174
US

V. Phone/Fax

Practice location:
  • Phone: 719-321-1577
  • Fax:
Mailing address:
  • Phone: 719-321-1577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPN.00997942-CNS
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberC-APN.0101624-C-CNS
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: