Provider Demographics
NPI:1538535810
Name:SHOENER, CHELSEY EILEEN
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:EILEEN
Last Name:SHOENER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 E BAYSHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-5358
Mailing Address - Country:US
Mailing Address - Phone:401-741-7729
Mailing Address - Fax:
Practice Address - Street 1:24 E BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5358
Practice Address - Country:US
Practice Address - Phone:401-741-7729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305209726225100000X
NC13251225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist