Provider Demographics
NPI:1033536271
Name:CANTIE, CHELSEY LAUREN (AGACNP-BC, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:LAUREN
Last Name:CANTIE
Suffix:
Gender:F
Credentials:AGACNP-BC, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 COLONIAL CIR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-1466
Mailing Address - Country:US
Mailing Address - Phone:585-739-6543
Mailing Address - Fax:
Practice Address - Street 1:20 COLONIAL CIR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1466
Practice Address - Country:US
Practice Address - Phone:585-739-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9323582363LA2100X, 363LP2300X
NY430875363LA2100X
NY307153363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health