Provider Demographics
NPI:1669109336
Name:GRAHAM, CHELSEA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9910 COUNTY ROAD 15
Mailing Address - Street 2:
Mailing Address - City:ZANESFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43360-9719
Mailing Address - Country:US
Mailing Address - Phone:937-508-3323
Mailing Address - Fax:
Practice Address - Street 1:212 E COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2033
Practice Address - Country:US
Practice Address - Phone:937-599-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily