Healthcare Provider Details

I. General information

NPI: 1821819624
Provider Name (Legal Business Name): CHELSEA CLARICE SCHORR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5772 INTEGRITY DR BLDG S771
MILLINGTON TN
38053-7258
US

IV. Provider business mailing address

7958 MARY LYNN CV
MILLINGTON TN
38053-2262
US

V. Phone/Fax

Practice location:
  • Phone: 901-874-6143
  • Fax: 901-874-6102
Mailing address:
  • Phone: 901-297-8811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number210305
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: