Provider Demographics
NPI:1073178067
Name:BRAVENEC, CHELSEY ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:CHELSEY
Middle Name:ANNE
Last Name:BRAVENEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6600 N DESERT BLVD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2441
Mailing Address - Country:US
Mailing Address - Phone:915-790-5700
Mailing Address - Fax:915-521-7554
Practice Address - Street 1:6600 N DESERT BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-2441
Practice Address - Country:US
Practice Address - Phone:915-790-5700
Practice Address - Fax:915-521-7554
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4320207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ149651Medicaid