Healthcare Provider Details

I. General information

NPI: 1831016088
Provider Name (Legal Business Name): CHELSEY KUBISIAK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 LIMESTONE OVERLOOK
GAINESVILLE GA
30501-7443
US

IV. Provider business mailing address

2324 LIMESTONE OVERLOOK
GAINESVILLE GA
30501-7443
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-8109
  • Fax: 770-536-3203
Mailing address:
  • Phone: 770-536-8109
  • Fax: 770-536-3203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP291587
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: