Healthcare Provider Details

I. General information

NPI: 1225787138
Provider Name (Legal Business Name): CHELSEA PROLLAMANTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 W HORIZON RIDGE PKWY
HENDERSON NV
89052-5788
US

IV. Provider business mailing address

2441 W HORIZON RIDGE PKWY
HENDERSON NV
89052-5788
US

V. Phone/Fax

Practice location:
  • Phone: 702-248-7337
  • Fax: 702-478-5465
Mailing address:
  • Phone: 702-248-7337
  • Fax: 702-478-5465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO3969
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: