Provider Demographics
NPI:1356816854
Name:KALUZNY, CHELCIE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CHELCIE
Middle Name:
Last Name:KALUZNY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3218
Mailing Address - Country:US
Mailing Address - Phone:910-248-4600
Mailing Address - Fax:
Practice Address - Street 1:102 W SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3218
Practice Address - Country:US
Practice Address - Phone:910-248-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013454363LF0000X
NM58136363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily