MEDICARE: CHELSEY OLGA SHERBURNE FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	A175794	IA

General Provider Information

NPI Number	:	1578246617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEY OLGA SHERBURNE FNP-C

Provider Business Mailing Address
First Line	:	2219 STATE HIGHWAY 76
Second Line	:
City	:	DORCHESTER
State	:	IA
Zip	:	52140-7533
Country	:	US
Telephone Number	:	507-459-7234
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 1ST ST SE
Second Line	:
City	:	WAUKON
State	:	IA
Zip	:	52172-2099
Country	:	US
Telephone Number	:	563-568-3411
Fax Number	:	563-568-6139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2023
Last Update Date	:	08/07/2023

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