Provider Demographics
NPI:1689560229
Name:CASTLEBERRY, CHELSEY NICCOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:NICCOLE
Last Name:CASTLEBERRY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5524 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-1325
Mailing Address - Country:US
Mailing Address - Phone:601-513-6195
Mailing Address - Fax:
Practice Address - Street 1:5524 19TH AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-1325
Practice Address - Country:US
Practice Address - Phone:601-513-6195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS907510363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner