Provider Demographics
NPI:1891133070
Name:JEWELL, CHELSEA MARIE
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:MARIE
Last Name:JEWELL
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 1:7 AMY MARIE CT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-2014
Mailing Address - Country:US
Mailing Address - Phone:518-221-1770
Mailing Address - Fax:
Practice Address - Street 1:7 AMY MARIE CT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-2014
Practice Address - Country:US
Practice Address - Phone:518-221-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304820-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse