Provider Demographics
NPI:1093140675
Name:ROBERTSON, CHELSEA ELAINE (RN)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ELAINE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 CARROUSEL LN
Mailing Address - Street 2:APT 2
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-5606
Mailing Address - Country:US
Mailing Address - Phone:608-669-4999
Mailing Address - Fax:
Practice Address - Street 1:2944 CARROUSEL LN
Practice Address - Street 2:APT 2
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-5606
Practice Address - Country:US
Practice Address - Phone:608-669-4999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI195463-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse