Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 201807163NP-PP | OR |
NPI | 1225519671 |
---|---|
Provider Name | Dr. Chelsea M Cieslak |
First Address | Chicago, IL 60622-8283 |
Second Address | Portland, OR 97227-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2018 |
Last Update Date | 23/08/2018 |