Provider Demographics
NPI:1669283636
Name:RODGERS, CHELSEY DAWN (RN, BSN, CLC)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:DAWN
Last Name:RODGERS
Suffix:
Gender:F
Credentials:RN, BSN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4960 S GILBERT RD STE 1-123
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5982
Mailing Address - Country:US
Mailing Address - Phone:480-466-0368
Mailing Address - Fax:
Practice Address - Street 1:4960 S GILBERT RD STE 1-123
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-5982
Practice Address - Country:US
Practice Address - Phone:480-466-0368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
362562174N00000X
AZ240401163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No174N00000XOther Service ProvidersLactation Consultant, Non-RN