Healthcare Provider Details

I. General information

NPI: 1770087595
Provider Name (Legal Business Name): CHELSEA LARSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA ROSS

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S WEST ST
WILMINGTON DE
19801-5014
US

IV. Provider business mailing address

125 S WEST ST
WILMINGTON DE
19801-5014
US

V. Phone/Fax

Practice location:
  • Phone: 302-428-4475
  • Fax: 302-428-4480
Mailing address:
  • Phone: 302-428-4475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0001144
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0001144
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP018599
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: