Provider Demographics
NPI:1669712378
Name:SMITH, CHELSEA (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5975 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-5826
Mailing Address - Country:US
Mailing Address - Phone:304-881-3855
Mailing Address - Fax:
Practice Address - Street 1:2827 5TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1435
Practice Address - Country:US
Practice Address - Phone:304-399-7182
Practice Address - Fax:304-523-7738
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY96900030Medicaid