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General NPI Number Information
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NPI Number | 1972008662
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Entity Type | Individual
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Provider Name | CHELSIA DANIELLE DERENARD CNP
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Gender | Female
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 1480 CENTER RD
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City | AVON
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State | OH
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Zip | 44011-1239
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Country | US
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Telephone | 440-937-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 237 BUTTERNUT LN
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City | BEREA
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State | OH
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Zip | 44017-1359
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Country | US
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Telephone | 330-323-2098
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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 | APRN.CNP.022549
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License Number State | OH
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