Provider Demographics
NPI:1851001598
Name:ANFINSON, CHELSEY
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:ANFINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:KENYON
Mailing Address - State:MN
Mailing Address - Zip Code:55946-1227
Mailing Address - Country:US
Mailing Address - Phone:507-330-1645
Mailing Address - Fax:
Practice Address - Street 1:223 S LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:MN
Practice Address - Zip Code:55041-1642
Practice Address - Country:US
Practice Address - Phone:651-345-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist