Provider Demographics
NPI:1235564816
Name:HARTMANN, CHELSEA ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANNE
Last Name:HARTMANN
Suffix:
Gender:F
Credentials:PA-C
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 1050
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54957-1050
Mailing Address - Country:US
Mailing Address - Phone:844-547-4343
Mailing Address - Fax:
Practice Address - Street 1:1524 S COMMERCIAL ST STE 2N
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-4999
Practice Address - Country:US
Practice Address - Phone:844-547-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3178-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant