Provider Demographics
NPI:1972120665
Name:MCGEE WALLEY, CHELSEA LYNNE (WHNP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNNE
Last Name:MCGEE WALLEY
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3850
Mailing Address - Country:US
Mailing Address - Phone:337-593-9099
Mailing Address - Fax:
Practice Address - Street 1:105 CORPORATE BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3850
Practice Address - Country:US
Practice Address - Phone:337-593-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA221879363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty