Healthcare Provider Details

I. General information

NPI: 1477099562
Provider Name (Legal Business Name): CHELSEA MAE HEJL APN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA OLSON

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W OTTLEY AVE
FRUITA CO
81521-2118
US

IV. Provider business mailing address

PO BOX 130
FRUITA CO
81521-0130
US

V. Phone/Fax

Practice location:
  • Phone: 970-858-2239
  • Fax: 970-858-0798
Mailing address:
  • Phone: 970-858-2186
  • Fax: 970-858-2208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0992940-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: