Provider Demographics
NPI:1477137776
Name:WEILAND, CHELSEA
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:WEILAND
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:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:50475-0370
Mailing Address - Country:US
Mailing Address - Phone:641-892-4640
Mailing Address - Fax:
Practice Address - Street 1:115 GILMAN ST
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:IA
Practice Address - Zip Code:50475
Practice Address - Country:US
Practice Address - Phone:641-892-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist