Provider Demographics
NPI:1568077428
Name:LAWTER, CHELSIE RAE (APRN)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:RAE
Last Name:LAWTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHELSIE
Other - Middle Name:RAE
Other - Last Name:FAULK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:78 DAY TRADE ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8842
Mailing Address - Country:US
Mailing Address - Phone:408-722-1062
Mailing Address - Fax:
Practice Address - Street 1:6900 N PECOS RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV811203363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health