Healthcare Provider Details

I. General information

NPI: 1750956702
Provider Name (Legal Business Name): CHELSEY HALEY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 PASTURE RD
FALLON NV
89406-3491
US

IV. Provider business mailing address

4755 PASTURE RD
FALLON NV
89406-3491
US

V. Phone/Fax

Practice location:
  • Phone: 754-263-1257
  • Fax:
Mailing address:
  • Phone: 775-426-3125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4903
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO3827
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: