Healthcare Provider Details

I. General information

NPI: 1104579010
Provider Name (Legal Business Name): CHELSEA COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2022
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 N MILITARY HWY
NORFOLK VA
23502-3716
US

IV. Provider business mailing address

1336 JENNIE SCHER RD
RICHMOND VA
23231-1035
US

V. Phone/Fax

Practice location:
  • Phone: 833-782-2229
  • Fax:
Mailing address:
  • Phone: 804-878-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: