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General NPI Number Information
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NPI Number | 1902573256
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Entity Type | Individual
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Provider Name | CHELSIE CHENILLE TOLER BUCKLEY PMHNP, APRN
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Gender | Female
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 103 CENTURY 21 DR STE 213
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City | JACKSONVILLE
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State | FL
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Zip | 32216-9295
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Country | US
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Telephone | 904-475-2039
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Fax |
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Provider Business Mailing Address
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Address Line | 12716 BLACK ANGUS DR
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City | JACKSONVILLE
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State | FL
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Zip | 32226-5837
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Country | US
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Telephone | 904-554-1835
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Fax | 904-289-8702
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11014972
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License Number State | FL
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