Provider Demographics
NPI:1275046054
Name:EDWARDS, CHELSEA Q (RD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:Q
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HUGHES POND CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-7372
Mailing Address - Country:US
Mailing Address - Phone:256-783-9530
Mailing Address - Fax:
Practice Address - Street 1:7738B MADISON BLVD STE 204
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806
Practice Address - Country:US
Practice Address - Phone:256-224-1665
Practice Address - Fax:833-629-8753
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2822133N00000X, 133NN1002X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education