Healthcare Provider Details

I. General information

NPI: 1033604277
Provider Name (Legal Business Name): CHELSEA WEILAND DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 29TH ST
GREELEY CO
80634-5474
US

IV. Provider business mailing address

2627 RIVERSIDE AVE
JACKSONVILLE FL
32204-4712
US

V. Phone/Fax

Practice location:
  • Phone: 970-652-2801
  • Fax: 970-652-2827
Mailing address:
  • Phone: 904-308-7372
  • Fax: 904-308-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0066031
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberUO5882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: