Provider Demographics
NPI:1679314926
Name:SMITH, CHELSEA MARIE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
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 1:451 BUSINESS LOOP RD
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-4544
Mailing Address - Country:US
Mailing Address - Phone:318-335-9143
Mailing Address - Fax:
Practice Address - Street 1:117 W MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-1706
Practice Address - Country:US
Practice Address - Phone:318-346-2288
Practice Address - Fax:318-346-2299
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA235638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily