Provider Demographics
NPI:1710304068
Name:POWELL, CHELSEA (MD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2214 CANTERBURY DR STE 204
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2375
Mailing Address - Country:US
Mailing Address - Phone:785-623-2360
Mailing Address - Fax:
Practice Address - Street 1:2214 CANTERBURY DR STE 204
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2375
Practice Address - Country:US
Practice Address - Phone:785-623-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-39691208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics