Provider Demographics
NPI:1053196436
Name:VAN WINKLE, CHELSY ELIZABETH (PA-C)
Entity type:Individual
Prefix:MS
First Name:CHELSY
Middle Name:ELIZABETH
Last Name:VAN WINKLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSY
Other - Middle Name:ELIZABETH
Other - Last Name:STOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:724 NW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6110
Mailing Address - Country:US
Mailing Address - Phone:352-332-7222
Mailing Address - Fax:352-333-5569
Practice Address - Street 1:724 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6110
Practice Address - Country:US
Practice Address - Phone:352-332-7222
Practice Address - Fax:352-333-5569
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117909363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant