Healthcare Provider Details

I. General information

NPI: 1750100855
Provider Name (Legal Business Name): CHELSEE NUTT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5730 GLENRIDGE DR STE T200
SANDY SPRINGS GA
30328-5873
US

IV. Provider business mailing address

5730 GLENRIDGE DR STE T200
SANDY SPRINGS GA
30328-5873
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-5428
  • Fax: 404-250-1881
Mailing address:
  • Phone: 404-256-5428
  • Fax: 404-250-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN1104257
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: