Provider Demographics
NPI:1922752401
Name:MYER, CHELSEA NICOLE (CHES)
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:NICOLE
Last Name:MYER
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 APRIL LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1508
Mailing Address - Country:US
Mailing Address - Phone:267-230-0579
Mailing Address - Fax:
Practice Address - Street 1:2500 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3367
Practice Address - Country:US
Practice Address - Phone:302-274-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA35184
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA35184OtherNATIONAL COMMISSION FOR HEALTH EDUCATION CREDENTIALING