Provider Demographics
NPI:1609391796
Name:HOMAN, CHELSEA LYNN (RN-BSN)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNN
Last Name:HOMAN
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 PREMIER DR STE 340
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6839
Mailing Address - Country:US
Mailing Address - Phone:507-345-8591
Mailing Address - Fax:507-345-5023
Practice Address - Street 1:1961 PREMIER DR #340
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003
Practice Address - Country:US
Practice Address - Phone:507-345-8591
Practice Address - Fax:507-345-5023
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR2448851163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse