Healthcare Provider Details

I. General information

NPI: 1033580121
Provider Name (Legal Business Name): CHELSEA MARIE OBERMEYER C.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

3200 BURNET AVE 3 SOUTH CREDENTIALING
CINCINNATI OH
45229-3019
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8521
  • Fax:
Mailing address:
  • Phone: 513-475-8521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number364987
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number18328-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: