Healthcare Provider Details

I. General information

NPI: 1457010506
Provider Name (Legal Business Name): CHELSEY LYNN MCANULTY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S JONES BLVD
LAS VEGAS NV
89146-1260
US

IV. Provider business mailing address

1901 S JONES BLVD
LAS VEGAS NV
89146-1260
US

V. Phone/Fax

Practice location:
  • Phone: 702-486-7865
  • Fax: 702-486-9653
Mailing address:
  • Phone: 702-486-7865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: