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General NPI Number Information
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NPI Number | 1477249464
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Entity Type | Individual
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Provider Name | CHLOE ELAINE KELLAM WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 8239 MEADOWBRIDGE RD STE A
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-2318
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Country | US
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Telephone | 757-633-1582
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Fax |
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Provider Business Mailing Address
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Address Line | 11921 CARTERS VALLEY TER
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City | CHESTERFIELD
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State | VA
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Zip | 23838-3054
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Country | US
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Telephone |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0024186899
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License Number State | VA
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