Provider Demographics
NPI:1083163208
Name:ONTKOS, CHELSEA LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LYNN
Last Name:ONTKOS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13946 MAGNOLIA RIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5371
Mailing Address - Country:US
Mailing Address - Phone:407-929-0055
Mailing Address - Fax:
Practice Address - Street 1:2831 MAGUIRE RD
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6057
Practice Address - Country:US
Practice Address - Phone:407-654-0568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9310222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily