Provider Demographics
NPI:1861197956
Name:STIMBERT, CHELSEA
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:STIMBERT
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 1:780 FORESTBERRY CT
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-2609
Mailing Address - Country:US
Mailing Address - Phone:248-830-7794
Mailing Address - Fax:
Practice Address - Street 1:15959 HALL RD STE LL104
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-5364
Practice Address - Country:US
Practice Address - Phone:586-799-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704274999363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care