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General NPI Number Information
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NPI Number | 1417518440
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Entity Type | Individual
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Provider Name | CHELSEA DANIELLE MASSEY
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Gender | Female
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 2700 EXECUTIVE PARK NW
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City | CLEVELAND
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State | TN
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Zip | 37312-2770
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Country | US
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Telephone | 423-605-1947
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Fax |
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Provider Business Mailing Address
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Address Line | 372 ARBOR POINTE TRL
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City | DAYTON
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State | TN
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Zip | 37321-4444
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Country | US
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Telephone | 423-605-1947
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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 | 26076
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License Number State | TN
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