Healthcare Provider Details

I. General information

NPI: 1407775125
Provider Name (Legal Business Name): CHELSEA HULL LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 CHURCH STREET STE 610 PMB 176
DECATUR GA
30033
US

IV. Provider business mailing address

3938 RIVERSIDE PKWY
DECATUR GA
30034-7335
US

V. Phone/Fax

Practice location:
  • Phone: 404-771-2822
  • Fax:
Mailing address:
  • Phone: 404-771-2822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: