Provider Demographics
NPI:1295202521
Name:WILLIAMS, CHELSEA DAWN
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:DAWN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 GREENDALE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2238
Mailing Address - Country:US
Mailing Address - Phone:757-709-8114
Mailing Address - Fax:
Practice Address - Street 1:1505 GREENDALE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2238
Practice Address - Country:US
Practice Address - Phone:757-709-8114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician