Provider Demographics
NPI:1952672057
Name:WORD, CHELSIE M (PA-C)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:M
Last Name:WORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSIE
Other - Middle Name:M
Other - Last Name:DUNDERLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 UNSER BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3936
Mailing Address - Country:US
Mailing Address - Phone:505-205-1271
Mailing Address - Fax:
Practice Address - Street 1:1800 UNSER BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-3936
Practice Address - Country:US
Practice Address - Phone:505-205-1271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5464363A00000X
NVPA1355363AS0400X
NMPA2021-0056363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical