Provider Demographics
NPI:1013550953
Name:WHALEN, CHELSEA M (LPN II)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:M
Last Name:WHALEN
Suffix:
Gender:F
Credentials:LPN II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 STATE ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NY
Mailing Address - Zip Code:13624-1325
Mailing Address - Country:US
Mailing Address - Phone:315-741-0932
Mailing Address - Fax:
Practice Address - Street 1:738 HIGH ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NY
Practice Address - Zip Code:13624-1510
Practice Address - Country:US
Practice Address - Phone:315-771-9774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325120164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse