Healthcare Provider Details

I. General information

NPI: 1225763485
Provider Name (Legal Business Name): CHELSEA RAE BORDERS CLARK FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 QUADRANGLE DR
CHAPEL HILL NC
27517-8279
US

IV. Provider business mailing address

8 N CHRISTIE CT
FLETCHER NC
28732-0699
US

V. Phone/Fax

Practice location:
  • Phone: 919-932-5700
  • Fax:
Mailing address:
  • Phone: 828-702-2750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5024276
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number254205
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: