Provider Demographics
NPI:1629125083
Name:UNSELD, CHANTEL EVE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHANTEL
Middle Name:EVE
Last Name:UNSELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OLD BLOOMFIELD PIKE STE 400
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004
Mailing Address - Country:US
Mailing Address - Phone:502-275-1683
Mailing Address - Fax:
Practice Address - Street 1:1115 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2749
Practice Address - Country:US
Practice Address - Phone:270-769-5963
Practice Address - Fax:270-769-9051
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA1006251363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner