Healthcare Provider Details

I. General information

NPI: 1518599976
Provider Name (Legal Business Name): CHELSIE JAMES CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 W UNDERWOOD ST
ORLANDO FL
32806-1110
US

IV. Provider business mailing address

603 TRELAGO WAY APT 106
MAITLAND FL
32751-4378
US

V. Phone/Fax

Practice location:
  • Phone: 821-841-5111
  • Fax:
Mailing address:
  • Phone: 404-931-4028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11007875
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: