Provider Demographics
NPI:1386998680
Name:KING, CHELSEA ELIZABETH (PA-C)
Entity type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:ELIZABETH
Last Name:KING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CHELSEA
Other - Middle Name:ELIZABETH
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-9762
Mailing Address - Country:US
Mailing Address - Phone:304-550-2065
Mailing Address - Fax:
Practice Address - Street 1:1710 HARPER RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3397
Practice Address - Country:US
Practice Address - Phone:304-256-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-006460363A00000X
WV589363AS0400X
WV01692363AS0400X
GA9236363A00000X
KY363A00000X
WV1692363A00000X
OH50.004327363A00000X
KYPA2338363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical