Provider Demographics
NPI:1336898055
Name:CLICK, CHELSY LYNN
Entity Type:Individual
Prefix:
First Name:CHELSY
Middle Name:LYNN
Last Name:CLICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 54
Mailing Address - Street 2:
Mailing Address - City:WARRIORMINE
Mailing Address - State:WV
Mailing Address - Zip Code:24894-0054
Mailing Address - Country:US
Mailing Address - Phone:304-320-2202
Mailing Address - Fax:
Practice Address - Street 1:728 SHOP HOLLOW RD.
Practice Address - Street 2:
Practice Address - City:WARRIORMINE
Practice Address - State:WV
Practice Address - Zip Code:24894
Practice Address - Country:US
Practice Address - Phone:304-320-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant