Provider Demographics
NPI:1619647815
Name:BIRCHFIELD, CHEALSEA ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:CHEALSEA
Middle Name:ANNE
Last Name:BIRCHFIELD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:TN
Mailing Address - Zip Code:37658-3250
Mailing Address - Country:US
Mailing Address - Phone:423-213-7584
Mailing Address - Fax:
Practice Address - Street 1:1009 NOVUS DR STE 1A
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-8237
Practice Address - Country:US
Practice Address - Phone:423-213-7584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-18
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN243291163W00000X
TN35474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse