Provider Demographics
NPI:1073186235
Name:NADEAU, CHELSI NICOLE HULDA
Entity Type:Individual
Prefix:
First Name:CHELSI
Middle Name:NICOLE HULDA
Last Name:NADEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2022
Mailing Address - Street 2:
Mailing Address - City:BELCOURT
Mailing Address - State:ND
Mailing Address - Zip Code:58316-2022
Mailing Address - Country:US
Mailing Address - Phone:701-278-5356
Mailing Address - Fax:
Practice Address - Street 1:3214 BIA 8 RD
Practice Address - Street 2:
Practice Address - City:BELCOURT
Practice Address - State:ND
Practice Address - Zip Code:58316-5831
Practice Address - Country:US
Practice Address - Phone:701-278-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND14707963747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant