Provider Demographics
NPI:1801563572
Name:CARLAN, CHELSEA LAW (AGNP)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LAW
Last Name:CARLAN
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:125 MILLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-9603
Mailing Address - Country:US
Mailing Address - Phone:336-613-3484
Mailing Address - Fax:
Practice Address - Street 1:621 S MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5034
Practice Address - Country:US
Practice Address - Phone:336-342-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCARL8DWFM363LG0600X
NC5015450363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology