Provider Demographics
NPI:1205333010
Name:BRAUNS, CHELSEA MARIE ROULEAU (NP-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE ROULEAU
Last Name:BRAUNS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:MARIE
Other - Last Name:ROULEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5525 GROSSMONT CENTER DR STE 602
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3009
Mailing Address - Country:US
Mailing Address - Phone:619-740-4770
Mailing Address - Fax:
Practice Address - Street 1:5525 GROSSMONT CENTER DR STE 602
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3009
Practice Address - Country:US
Practice Address - Phone:619-740-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008864363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health