Provider Demographics
NPI:1801504915
Name:BOSTELMAN, CHELSEA M (AGCNS-BC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:M
Last Name:BOSTELMAN
Suffix:
Gender:F
Credentials:AGCNS-BC
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:M
Other - Last Name:GERKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:754 DAFFODIL ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-4174
Mailing Address - Country:US
Mailing Address - Phone:719-321-1577
Mailing Address - Fax:
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6819
Practice Address - Country:US
Practice Address - Phone:719-321-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.00997942-CNS364S00000X
COC-APN.0101624-C-CNS364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health