Provider Demographics
NPI:1851007959
Name:SWEETMAN, CHELSEA AMBER
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:AMBER
Last Name:SWEETMAN
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 1:5655 W HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-9640
Mailing Address - Country:US
Mailing Address - Phone:585-727-8831
Mailing Address - Fax:
Practice Address - Street 1:5655 W HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9640
Practice Address - Country:US
Practice Address - Phone:585-727-8831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345863164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse