Provider Demographics
NPI:1831963099
Name:CHOSEN NURSING CONSULTANT
Entity type:Organization
Organization Name:CHOSEN NURSING CONSULTANT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:UPSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-349-2175
Mailing Address - Street 1:2285 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-3154
Mailing Address - Country:US
Mailing Address - Phone:225-218-5647
Mailing Address - Fax:225-529-3821
Practice Address - Street 1:2285 NORTH ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-3154
Practice Address - Country:US
Practice Address - Phone:225-218-5647
Practice Address - Fax:225-529-3821
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHOSEN NURSING CONSULTANT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-08
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty