Healthcare Provider Details

I. General information

NPI: 1376096222
Provider Name (Legal Business Name): CHELSEY ANN SHAVER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 10/19/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PRINCE AVE
ATHENS GA
30606-2797
US

IV. Provider business mailing address

1199 PRINCE AVE
ATHENS GA
30606-2797
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-5076
  • Fax:
Mailing address:
  • Phone: 706-475-7000
  • Fax: 706-475-7113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN190790
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberRN190790
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: