Provider Demographics
NPI:1669750444
Name:COMMANDER, CHELSEA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNN
Last Name:COMMANDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98035
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70898-9035
Mailing Address - Country:US
Mailing Address - Phone:225-766-0050
Mailing Address - Fax:
Practice Address - Street 1:7301 HENNESSY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4384
Practice Address - Country:US
Practice Address - Phone:225-766-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06569363L00000X
LARN115709363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2162144Medicaid
LA3C606CQ60Medicare PIN