Provider Demographics
NPI:1801610274
Name:SISNEROS, CHELSEY (CNP)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:SISNEROS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 CORAL SATIN CT NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-3043
Mailing Address - Country:US
Mailing Address - Phone:505-362-4612
Mailing Address - Fax:
Practice Address - Street 1:5505 OSUNA RD NE STE F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-2542
Practice Address - Country:US
Practice Address - Phone:505-362-4612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM81648363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner