1861914871 NPI number — CHELSEA NORMAN RDN, CD

Table of content: CHELSEA NORMAN RDN, CD (NPI 1861914871)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861914871 NPI number — CHELSEA NORMAN RDN, CD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NORMAN
Provider First Name:
CHELSEA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RDN, CD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PREEDY
Provider Other First Name:
CHELSEA
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1861914871
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
295 CHIPETA WAY
Provider Second Line Business Mailing Address:
ATTN: DEPARTMENT OF PEDS, DIVISION OF MEDICAL GENETICS
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84108-1287
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-587-0413
Provider Business Mailing Address Fax Number:
801-585-7252

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
81 N MARIO CAPECCHI DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84113-1125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-662-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133VN1006X , with the licence number:  86040226 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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