Provider Demographics
NPI:1790424422
Name:PASSWATER, CHELSEA (APRN, CNS, AGCNS-BC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:PASSWATER
Suffix:
Gender:F
Credentials:APRN, CNS, AGCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4348 GLEN CASTLE WAY
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-2303
Mailing Address - Country:US
Mailing Address - Phone:252-714-8948
Mailing Address - Fax:
Practice Address - Street 1:4348 GLEN CASTLE WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-847-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC456364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health