Provider Demographics
NPI:1376207928
Name:SIMERLY, CHELSEY BROOKE (APRN)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:BROOKE
Last Name:SIMERLY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 VERVILLA RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-6032
Mailing Address - Country:US
Mailing Address - Phone:931-205-0629
Mailing Address - Fax:
Practice Address - Street 1:455 N CHANCERY ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2049
Practice Address - Country:US
Practice Address - Phone:931-474-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30622363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care