Healthcare Provider Details

I. General information

NPI: 1730971094
Provider Name (Legal Business Name): CHELSEY STAFFORD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 9
CONWAY MO
65632-0009
US

IV. Provider business mailing address

PO BOX 9
CONWAY MO
65632-0009
US

V. Phone/Fax

Practice location:
  • Phone: 417-589-5046
  • Fax: 417-281-3389
Mailing address:
  • Phone: 417-589-5046
  • Fax: 417-281-3389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025017599
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: