Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 5951001236 | MI |
Y | 222Z00000X | Podiatrist | 5951001236 | MI |
N | 213ES0103X | Foot & Ankle Surgery | E5826 | CA |
NPI | 1083104319 |
---|---|
Provider Name | Chelsea Anne Nakano |
First Address | Grand Blanc, MI 48439-8065 |
Second Address | Orange, CA 92866-2111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2018 |
Last Update Date | 25/01/2022 |