Provider Demographics
NPI:1104367978
Name:SKAZA, CHELSEA (NP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:SKAZA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:SLOZAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-2354
Mailing Address - Country:US
Mailing Address - Phone:413-237-2725
Mailing Address - Fax:
Practice Address - Street 1:366 KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2333
Practice Address - Country:US
Practice Address - Phone:413-586-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2274333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily