Provider Demographics
NPI:1215282520
Name:MEACHUM, CHELSEY C (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:C
Last Name:MEACHUM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSEY
Other - Middle Name:C
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:11842 ROCK LANDING DR STE 115
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4437
Mailing Address - Country:US
Mailing Address - Phone:757-595-9905
Mailing Address - Fax:
Practice Address - Street 1:11842 ROCK LANDING DR STE 115
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4437
Practice Address - Country:US
Practice Address - Phone:757-595-9905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110006642363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant