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General NPI Number Information
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NPI Number | 1295330603
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Entity Type | Individual
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Provider Name | DR. CHELSEA HARLAN
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 2051 S BEND AVE
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City | SOUTH BEND
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State | IN
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Zip | 46637-5686
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Country | US
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Telephone | 574-273-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 171 HINCHMAN RD
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City | BARODA
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State | MI
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Zip | 49101-9717
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Country | US
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Telephone | 269-326-0236
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 27027722A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302046382
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26027722A
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License Number State | IN
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