Healthcare Provider Details

I. General information

NPI: 1700517455
Provider Name (Legal Business Name): CHELSEA BAKER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHELSEA NICOLE SHRUM

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 WOLVERINE TRL
SMYRNA TN
37167-5656
US

IV. Provider business mailing address

119 BONNIE OAK DR
LEBANON TN
37087-2981
US

V. Phone/Fax

Practice location:
  • Phone: 615-768-5511
  • Fax:
Mailing address:
  • Phone: 615-587-1720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number31933
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: