Provider Demographics
NPI:1881125706
Name:FREELS, CHELSEA MANGIA (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MANGIA
Last Name:FREELS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:RENEE
Other - Last Name:MANGIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:193 CARMEL CT
Mailing Address - Street 2:
Mailing Address - City:THORNVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43076-8372
Mailing Address - Country:US
Mailing Address - Phone:740-405-8034
Mailing Address - Fax:
Practice Address - Street 1:1850 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-1512
Practice Address - Country:US
Practice Address - Phone:740-405-8034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004736RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant