Provider Demographics
NPI:1548999196
Name:BEITZ, CHELSEA ANN (LPN)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANN
Last Name:BEITZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ANN
Other - Last Name:DONAIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1246
Mailing Address - Country:US
Mailing Address - Phone:315-296-8295
Mailing Address - Fax:
Practice Address - Street 1:31 6TH ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1246
Practice Address - Country:US
Practice Address - Phone:518-483-3261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343085164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse