Provider Demographics
NPI:1518470988
Name:DYCK, CHELSEA ELIZABETH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:ELIZABETH
Last Name:DYCK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12560 SAINT CROIX TRL N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-8532
Mailing Address - Country:US
Mailing Address - Phone:612-209-3433
Mailing Address - Fax:
Practice Address - Street 1:701 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415
Practice Address - Country:US
Practice Address - Phone:612-873-5014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1961164163WN0800X
MN2149367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience