Healthcare Provider Details

I. General information

NPI: 1275979791
Provider Name (Legal Business Name): CHELSEY SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5703 STEUBENVILLE PIKE
MC KEES ROCKS PA
15136
US

IV. Provider business mailing address

5703 STEUBENVILLE PIKE
MC KEES ROCKS PA
15136-1310
US

V. Phone/Fax

Practice location:
  • Phone: 412-788-4676
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP012845
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: