Provider Demographics
NPI:1255042875
Name:LOESER, CHELSIE ANN (NP)
Entity type:Individual
Prefix:
First Name:CHELSIE
Middle Name:ANN
Last Name:LOESER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 S TUTTLE RD
Mailing Address - Street 2:
Mailing Address - City:CUSTER
Mailing Address - State:MI
Mailing Address - Zip Code:49405-9750
Mailing Address - Country:US
Mailing Address - Phone:231-233-7730
Mailing Address - Fax:
Practice Address - Street 1:5656 W US HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2454
Practice Address - Country:US
Practice Address - Phone:231-843-2543
Practice Address - Fax:231-843-2547
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704330236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily