Healthcare Provider Details

I. General information

NPI: 1952265167
Provider Name (Legal Business Name): CHELSEA MANASCO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5564 LITTLE DEBBIE PKWY STE 114
OOLTEWAH TN
37363-4333
US

IV. Provider business mailing address

5564 LITTLE DEBBIE PKWY STE 114
OOLTEWAH TN
37363-4333
US

V. Phone/Fax

Practice location:
  • Phone: 423-602-9545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number37665
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: