Healthcare Provider Details

I. General information

NPI: 1669712378
Provider Name (Legal Business Name): CHELSEA SMITH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA BOWEN

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2827 5TH AVE
HUNTINGTON WV
25702-1435
US

IV. Provider business mailing address

5975 SYCAMORE RD
HURRICANE WV
25526-5826
US

V. Phone/Fax

Practice location:
  • Phone: 304-399-7182
  • Fax: 304-523-7738
Mailing address:
  • Phone: 304-881-3855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: