Provider Demographics
NPI:1740713767
Name:HARRIS, CHELSEA ANN (RN)
Entity type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:ANN
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8087 WASHINGTON VILLAGE DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1840
Mailing Address - Country:US
Mailing Address - Phone:937-203-4848
Mailing Address - Fax:937-203-4370
Practice Address - Street 1:8087 WASHINGTON VILLAGE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1840
Practice Address - Country:US
Practice Address - Phone:937-203-4848
Practice Address - Fax:937-203-4370
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN389200163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse