Provider Demographics
NPI:1669658837
Name:MANSFIELD, CHELSEA R (APRN)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:R
Last Name:MANSFIELD
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 1:920 OLIVER RD
Mailing Address - Street 2:SUITE 1600 B
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5702
Mailing Address - Country:US
Mailing Address - Phone:318-327-6220
Mailing Address - Fax:
Practice Address - Street 1:920 OLIVER RD
Practice Address - Street 2:SUITE 1600 B
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5702
Practice Address - Country:US
Practice Address - Phone:318-327-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA102599207P00000X
LAAP05342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA05342OtherAPRN
LA1030040Medicaid
LA3A546DF59Medicare PIN
LA1030040Medicaid