Basic Information
| Provider Information | |||||||||
| NPI: | 1194188961 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ISAAC | ||||||||
| FirstName: | CHELSEA | ||||||||
| MiddleName: | |||||||||
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| Credential: | FNP | ||||||||
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| OtherLastName: | WALKER | ||||||||
| OtherFirstName: | CHELSEA | ||||||||
| OtherMiddleName: | R | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1503 N MITTHOEFFER RD | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462292425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173559334 | ||||||||
| FaxNumber: | 3173556150 | ||||||||
| Practice Location | |||||||||
| Address1: | 1107 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461401207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3174775263 | ||||||||
| FaxNumber: | 3174776750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2016 | ||||||||
| LastUpdateDate: | 05/01/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 71006181A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 28190961A | IN | N | Nursing Service Providers | Registered Nurse |
No ID Information.