Healthcare Provider Details

I. General information

NPI: 1891185427
Provider Name (Legal Business Name): CHELSEA WHITNEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHELSEA CLIFFORD

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 02/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W 7TH AVE
EUGENE OR
97401-1100
US

IV. Provider business mailing address

2073 OLYMPIC ST
SPRINGFIELD OR
97477-3413
US

V. Phone/Fax

Practice location:
  • Phone: 541-682-4041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number201042957RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: