Provider Demographics
NPI:1821886649
Name:YELLOWTAIL, CHELSEY (FNP-C)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:YELLOWTAIL
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 981
Mailing Address - Street 2:
Mailing Address - City:RANCHESTER
Mailing Address - State:WY
Mailing Address - Zip Code:82839-0981
Mailing Address - Country:US
Mailing Address - Phone:605-209-1353
Mailing Address - Fax:
Practice Address - Street 1:1415 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2629
Practice Address - Country:US
Practice Address - Phone:307-752-1849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAPRN-262090363LF0000X
WY44580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily