Basic Information
Provider Information
NPI: 1538628656
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POE
FirstName: CHELSEA
MiddleName: RICE
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1021 DARRINGTON DR STE 101
Address2:  
City: CARY
State: NC
PostalCode: 275138158
CountryCode: US
TelephoneNumber: 9198523999
FaxNumber: 9193789114
Practice Location
Address1: 300 MACK RD STE B
Address2:  
City: ASHEBORO
State: NC
PostalCode: 272051066
CountryCode: US
TelephoneNumber: 3366251172
FaxNumber: 3366256434
Other Information
ProviderEnumerationDate: 03/18/2019
LastUpdateDate: 10/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X5011589NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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