Healthcare Provider Details

I. General information

NPI: 1043028285
Provider Name (Legal Business Name): CHELSEA OKORAFOR CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 CESAR CHAVEZ ST
SAINT PAUL MN
55107-2226
US

IV. Provider business mailing address

992 BELLOWS ST
SAINT PAUL MN
55118-1320
US

V. Phone/Fax

Practice location:
  • Phone: 651-602-7500
  • Fax:
Mailing address:
  • Phone: 763-354-4452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number612
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: