1043756125 NPI number — MRS. CHELSEA NOELLE ADELMANN RBT

Table of content: MRS. CHELSEA NOELLE ADELMANN RBT (NPI 1043756125)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043756125 NPI number — MRS. CHELSEA NOELLE ADELMANN RBT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADELMANN
Provider First Name:
CHELSEA
Provider Middle Name:
NOELLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RBT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAIRD
Provider Other First Name:
CHELSEA
Provider Other Middle Name:
NOELLE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RBT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043756125
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9615B MISSOURI ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OSCODA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48750-1956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-648-0856
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9615B MISSOURI ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSCODA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48750-1956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-648-0856
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2017

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: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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