Provider Demographics
NPI:1821686478
Name:MATTOX, CHELSIE ALLISON (WHNP)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:ALLISON
Last Name:MATTOX
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 JOHN PLATT DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4389
Mailing Address - Country:US
Mailing Address - Phone:252-247-1600
Mailing Address - Fax:252-247-1620
Practice Address - Street 1:3511 JOHN PLATT DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4389
Practice Address - Country:US
Practice Address - Phone:252-247-1600
Practice Address - Fax:252-247-1620
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013948363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health