Provider Demographics
NPI:1235697327
Name:STAUBACH, CHELSEA LYNNE (RN)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNNE
Last Name:STAUBACH
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 1:9997 CARVER RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5537
Mailing Address - Country:US
Mailing Address - Phone:513-348-7763
Mailing Address - Fax:
Practice Address - Street 1:9997 CARVER RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-5537
Practice Address - Country:US
Practice Address - Phone:513-348-7763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator