Provider Demographics
NPI:1306298393
Name:TAULMAN, CHELSEA
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:TAULMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:692 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MONON
Mailing Address - State:IN
Mailing Address - Zip Code:47959-8191
Mailing Address - Country:US
Mailing Address - Phone:877-797-2404
Mailing Address - Fax:
Practice Address - Street 1:692 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MONON
Practice Address - State:IN
Practice Address - Zip Code:47959-8191
Practice Address - Country:US
Practice Address - Phone:877-797-2404
Practice Address - Fax:877-727-7640
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006375A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily