Provider Demographics
NPI:1750949855
Name:KLEIN, CHELSEA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10371 W 6TH PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5604
Mailing Address - Country:US
Mailing Address - Phone:701-306-5831
Mailing Address - Fax:
Practice Address - Street 1:4895 RIVERBEND RD STE A
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2640
Practice Address - Country:US
Practice Address - Phone:720-279-9098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0773363A00000X
COPA0005648363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant