Provider Demographics
NPI:1376078436
Name:HEPBURN, CHELSEE L (CNP)
Entity Type:Individual
Prefix:
First Name:CHELSEE
Middle Name:L
Last Name:HEPBURN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CHELSEE
Other - Middle Name:L
Other - Last Name:HALSETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1287 HEWITT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-1424
Mailing Address - Country:US
Mailing Address - Phone:970-697-9050
Mailing Address - Fax:
Practice Address - Street 1:9400 ZANE AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1814
Practice Address - Country:US
Practice Address - Phone:612-274-7516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1629026163W00000X
MN7449363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse