Provider Demographics
NPI:1295474229
Name:FARNSWORTH, CHELSEA M (APRN-CNP, CNE, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:M
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:APRN-CNP, CNE, FNP-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:M
Other - Last Name:KACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5809
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83303-5809
Mailing Address - Country:US
Mailing Address - Phone:208-933-4440
Mailing Address - Fax:
Practice Address - Street 1:1309 BLUE LAKES BLVD N
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3310
Practice Address - Country:US
Practice Address - Phone:208-933-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID72975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily