Provider Demographics
NPI:1639810096
Name:HICKEY, CHELSEA LYNN (AG-ACNP)
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:LYNN
Last Name:HICKEY
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11735 COLONY LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-2043
Mailing Address - Country:US
Mailing Address - Phone:727-237-3152
Mailing Address - Fax:
Practice Address - Street 1:11735 COLONY LAKES BLVD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-2043
Practice Address - Country:US
Practice Address - Phone:727-237-3152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018972363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care