Provider Demographics
NPI:1629341334
Name:PHILPOT, CHELSEY BLAKE (APRN)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:BLAKE
Last Name:PHILPOT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 HIGHWAY 30 BYP STE 2
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-6139
Mailing Address - Country:US
Mailing Address - Phone:606-878-1181
Mailing Address - Fax:606-878-1267
Practice Address - Street 1:2135 HIGHWAY 30 BYP
Practice Address - Street 2:SUITE 2
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-6139
Practice Address - Country:US
Practice Address - Phone:606-878-1181
Practice Address - Fax:606-878-1267
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007337363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
F0112259OtherAMERICAN ACADAMY OF NURSE PRACTITIONERS CERTIFICATION NUMBER
KY3007337OtherAPRN NUMBER