Provider Demographics
NPI:1740467802
Name:VOTH, CHELSEA RENEE (PAC)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:RENEE
Last Name:VOTH
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5572
Mailing Address - Country:US
Mailing Address - Phone:620-275-9752
Mailing Address - Fax:
Practice Address - Street 1:310 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5572
Practice Address - Country:US
Practice Address - Phone:620-275-9752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1367363A00000X
KS15-01478363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1367OtherSTATE OF NEBRASKA DHHS
KS15-01478OtherKANSAS STATE BOARD OF HEALTH AND HUMAN SERVICES