Provider Demographics
NPI:1811696750
Name:WALSH, CHELSEA JEAN (CPNP-PC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:JEAN
Last Name:WALSH
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:JEAN
Other - Last Name:COCHRANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4508 EMMIT DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4792
Mailing Address - Country:US
Mailing Address - Phone:330-232-0696
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-684-2410
Practice Address - Fax:919-613-4581
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017753363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics