Provider Demographics
NPI:1669956595
Name:CHELSEA YOUMANS, FNP LLC
Entity type:Organization
Organization Name:CHELSEA YOUMANS, FNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:RIA
Authorized Official - Last Name:YOUMANS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:907-247-8783
Mailing Address - Street 1:3528 TONGASS AVE
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-5635
Mailing Address - Country:US
Mailing Address - Phone:907-243-8783
Mailing Address - Fax:
Practice Address - Street 1:3528 TONGASS AVE
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5635
Practice Address - Country:US
Practice Address - Phone:907-247-8783
Practice Address - Fax:844-742-6548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA009851100Medicaid