Healthcare Provider Details

I. General information

NPI: 1134062888
Provider Name (Legal Business Name): CHELSEY UMBLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

785 SUMMERSVILLE LAKE RD
MOUNT NEBO WV
26679-9203
US

IV. Provider business mailing address

PO BOX 569
MOUNT NEBO WV
26679-0569
US

V. Phone/Fax

Practice location:
  • Phone: 304-883-2334
  • Fax: 304-883-2334
Mailing address:
  • Phone: 304-883-2334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: