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General NPI Number Information
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NPI Number | 1427423334
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Entity Type | Individual
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Provider Name | CHELSEE NICOLE EWELL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/20/2015
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Provider Practice Location Address
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Address Line | 42136 BIG BEAR BLVD
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City | BIG BEAR LAKE
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State | CA
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Zip | 92315-1530
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Country | US
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Telephone | 909-878-0060
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Fax | 909-878-3362
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Provider Business Mailing Address
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Address Line | PO BOX 6966
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City | BIG BEAR LAKE
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State | CA
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Zip | 92315-6966
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Country | US
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Telephone | 909-878-0060
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Fax | 909-878-3362
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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 | 73692
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License Number State | CA
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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 | 84108631701
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License Number State | UT
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