Healthcare Provider Details

I. General information

NPI: 1033673769
Provider Name (Legal Business Name): CHELSEA WALKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 BLACK GOLD BLVD STE 106
HAZARD KY
41701-2620
US

IV. Provider business mailing address

PO BOX 959
HAZARD KY
41702-0959
US

V. Phone/Fax

Practice location:
  • Phone: 606-436-0711
  • Fax: 606-436-0848
Mailing address:
  • Phone: 606-436-0711
  • Fax: 606-435-1322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3013023
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: