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General NPI Number Information
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NPI Number | 1164029484
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Entity Type | Individual
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Provider Name | CHELSEA LAUREN BRESNAHAN
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Gender | Female
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 7928 S PARWAY LN
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City | CHENEY
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State | WA
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Zip | 99004-8619
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Country | US
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Telephone | 509-521-9481
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Fax |
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Provider Business Mailing Address
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Address Line | 7928 S PARWAY LN
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City | CHENEY
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State | WA
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Zip | 99004-8619
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Country | US
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Telephone | 509-521-9481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61005916
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License Number State | WA
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