Provider Demographics
NPI:1689373961
Name:POWELL, CHELLIE TERRY (CD, PCD, DONA)
Entity Type:Individual
Prefix:
First Name:CHELLIE
Middle Name:TERRY
Last Name:POWELL
Suffix:
Gender:F
Credentials:CD, PCD, DONA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 COTTONWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3412
Mailing Address - Country:US
Mailing Address - Phone:310-541-9467
Mailing Address - Fax:
Practice Address - Street 1:35 COTTONWOOD CIR
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3412
Practice Address - Country:US
Practice Address - Phone:310-541-9467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing