Provider Demographics
NPI:1659654531
Name:PONDER, CHELSEA E (MSN, RN, ACNP)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:E
Last Name:PONDER
Suffix:
Gender:F
Credentials:MSN, RN, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1073 N JAMESTOWN RD
Mailing Address - Street 2:APARTMENT I
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3623
Mailing Address - Country:US
Mailing Address - Phone:404-583-5177
Mailing Address - Fax:
Practice Address - Street 1:1073 N JAMESTOWN RD
Practice Address - Street 2:APARTMENT I
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3623
Practice Address - Country:US
Practice Address - Phone:404-583-5177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN193182363LA2100X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine