Provider Demographics
NPI:1609287010
Name:JOHNSON, CHELSEA NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:NICOLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 SOUTH BAGDAD ROAD
Mailing Address - Street 2:NORTH AUSTIN PEDIATRICS
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641
Mailing Address - Country:US
Mailing Address - Phone:512-260-0101
Mailing Address - Fax:855-862-9297
Practice Address - Street 1:709 SOUTH BAGDAD ROAD
Practice Address - Street 2:NORTH AUSTIN PEDIATRICS
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641
Practice Address - Country:US
Practice Address - Phone:512-260-0101
Practice Address - Fax:855-862-9297
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3352208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics