Provider Demographics
NPI:1497581441
Name:BURDEN, CHELSEY Z
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:Z
Last Name:BURDEN
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 1:284 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-6260
Mailing Address - Country:US
Mailing Address - Phone:740-616-0436
Mailing Address - Fax:
Practice Address - Street 1:284 OHIO ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-6260
Practice Address - Country:US
Practice Address - Phone:740-616-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide