Healthcare Provider Details

I. General information

NPI: 1356086433
Provider Name (Legal Business Name): CHELSEA ELAINE-FARQUHAR ZYBURT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-7081
US

IV. Provider business mailing address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-7081
US

V. Phone/Fax

Practice location:
  • Phone: 202-344-7104
  • Fax:
Mailing address:
  • Phone: 717-770-4180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR272879
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: