Provider Demographics
NPI:1699347054
Name:BLUE-SNEED, CHELSEY MARIE (LPN)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:MARIE
Last Name:BLUE-SNEED
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5956B KAMIAKIN TRL
Mailing Address - Street 2:
Mailing Address - City:FAIRCHILD AFB
Mailing Address - State:WA
Mailing Address - Zip Code:99011-2210
Mailing Address - Country:US
Mailing Address - Phone:228-243-1853
Mailing Address - Fax:
Practice Address - Street 1:4305 E TRENT AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-2339
Practice Address - Country:US
Practice Address - Phone:509-495-1207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP61132195164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse