MEDICARE: MRS. CHELSEA SMALL APRN

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	11010325	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770185746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHELSEA SMALL APRN

Provider Business Mailing Address
First Line	:	8831 IMMOKALEE RD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-3914
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7273 VANDERBILT BEACH RD STE 19
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-1478
Country	:	US
Telephone Number	:	317-900-1633
Fax Number	:

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

Provider Enumeration Date	:	11/13/2020
Last Update Date	:	09/20/2023

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