Provider Demographics
NPI:1932580784
Name:MCNABB PENDER, CHELSEY S (MD)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:S
Last Name:MCNABB PENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHELSEY
Other - Middle Name:S
Other - Last Name:MCNABB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2500 E CAPITOL DR STE 1200
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-8735
Mailing Address - Country:US
Mailing Address - Phone:920-731-5811
Mailing Address - Fax:920-358-1185
Practice Address - Street 1:2500 E CAPITOL DR STE 1200
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-8735
Practice Address - Country:US
Practice Address - Phone:920-731-5811
Practice Address - Fax:920-358-1185
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107362207R00000X, 208000000X
WI71263208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist