Provider Demographics
NPI:1295019941
Name:KRECH, CHELSA EVERLEY (MSN, ARNP, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHELSA
Middle Name:EVERLEY
Last Name:KRECH
Suffix:
Gender:F
Credentials:MSN, ARNP, PMHNP-BC
Other - Prefix:MISS
Other - First Name:CHELSA
Other - Middle Name:DAWN
Other - Last Name:EVERLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, PMHNP-BC
Mailing Address - Street 1:102 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-3611
Mailing Address - Country:US
Mailing Address - Phone:217-851-5841
Mailing Address - Fax:563-726-7522
Practice Address - Street 1:102 FOREST RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-3611
Practice Address - Country:US
Practice Address - Phone:217-851-5841
Practice Address - Fax:563-726-7522
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011032979363LP0808X
IL209009820363LP0808X
IAG143507363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health