Provider Demographics
NPI:1780243279
Name:WARNOCK, CHELSEA LYNN (MS, RD, CSP, LD)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LYNN
Last Name:WARNOCK
Suffix:
Gender:F
Credentials:MS, RD, CSP, LD
Other - Prefix:MS
Other - First Name:CHELSEA
Other - Middle Name:LYNN
Other - Last Name:COPHERANHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:1547 STUBBS ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2307
Mailing Address - Country:US
Mailing Address - Phone:806-731-0121
Mailing Address - Fax:
Practice Address - Street 1:1547 STUBBS ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2307
Practice Address - Country:US
Practice Address - Phone:806-731-0121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84408133VN1004X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric