Healthcare Provider Details

I. General information

NPI: 1669246203
Provider Name (Legal Business Name): CHELSEY LASHAEA SLAVEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEY LASHAEA MYERS

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 RAIDER WAY
STEAMS KY
42647-6110
US

IV. Provider business mailing address

PO BOX 1080
BURKESVILLE KY
42717-1080
US

V. Phone/Fax

Practice location:
  • Phone: 844-435-0900
  • Fax: 270-858-4029
Mailing address:
  • Phone: 270-864-1472
  • Fax: 270-864-1693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4011671
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number35067
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: