Provider Demographics
NPI:1134887466
Name:BRYAN, CHELSEA BRIANA (LM, CPM)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:BRIANA
Last Name:BRYAN
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 GRACIE RD
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-3604
Mailing Address - Country:US
Mailing Address - Phone:530-277-1895
Mailing Address - Fax:
Practice Address - Street 1:401 GRACIE RD
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-3604
Practice Address - Country:US
Practice Address - Phone:530-277-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA640176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife