Healthcare Provider Details

I. General information

NPI: 1730737859
Provider Name (Legal Business Name): CHELSEA ELIZABETH MILLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA ELIZABETH MANES PA-C

II. Dates (important events)

Enumeration Date: 09/02/2019
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD FL 3
NEWARK DE
19718-2200
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD FL 3
NEWARK DE
19718-2200
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-3475
  • Fax: 302-325-7056
Mailing address:
  • Phone: 302-733-3475
  • Fax: 302-325-7056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0001399
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: