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General NPI Number Information
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NPI Number | 1467113696
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Entity Type | Individual
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Provider Name | CHELSEA LINEBERRY
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Gender | Female
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 60 HIGHLAND CT
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City | ELLIJAY
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State | GA
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Zip | 30540-6773
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Country | US
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Telephone | 706-698-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 150 OLD LAKE LN
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City | DAWSONVILLE
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State | GA
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Zip | 30534-8713
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Country | US
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Telephone | 404-663-5340
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN239565
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License Number State | GA
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