Provider Demographics
NPI:1942173190
Name:MOORE, CHELSEA BOLING (APRN, FNP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:BOLING
Last Name:MOORE
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 RUSSELL AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-2204
Mailing Address - Country:US
Mailing Address - Phone:865-471-2000
Mailing Address - Fax:
Practice Address - Street 1:1646 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-2204
Practice Address - Country:US
Practice Address - Phone:865-471-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN181742163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse