Provider Demographics
NPI:1386175016
Name:ASHCROFT, CHELSEA MARIE (NURSE PRACTITIONER I)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:MARIE
Last Name:ASHCROFT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:482 BLACK RIVER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-2416
Mailing Address - Country:US
Mailing Address - Phone:315-782-1777
Mailing Address - Fax:315-785-8628
Practice Address - Street 1:7550 SOUTH STATE STREET
Practice Address - Street 2:
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367-1574
Practice Address - Country:US
Practice Address - Phone:315-376-5450
Practice Address - Fax:315-376-7221
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY673445163W00000X
NY673445-1163W00000X
NYF402161-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse