Provider Demographics
NPI:1346765278
Name:PARNELL, CHELSEA BROOK
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:BROOK
Last Name:PARNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:BROOK
Other - Last Name:PARNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1051 S RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-4303
Mailing Address - Country:US
Mailing Address - Phone:931-645-2494
Mailing Address - Fax:931-919-1218
Practice Address - Street 1:1051 S RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-4303
Practice Address - Country:US
Practice Address - Phone:931-645-2494
Practice Address - Fax:931-919-1218
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000055269183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician