Provider Demographics
NPI:1962049254
Name:PLAKOSH, CHELSEA RAE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:RAE
Last Name:PLAKOSH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:CHELSEA
Other - Middle Name:RAE
Other - Last Name:WATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2299 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-4674
Mailing Address - Country:US
Mailing Address - Phone:724-378-8484
Mailing Address - Fax:
Practice Address - Street 1:2299 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-4674
Practice Address - Country:US
Practice Address - Phone:724-544-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty