Provider Demographics
NPI:1043905961
Name:SANFORD, CHELSEY NOELLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:CHELSEY
Middle Name:NOELLE
Last Name:SANFORD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 OLD PADONIA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-4949
Mailing Address - Country:US
Mailing Address - Phone:443-761-6570
Mailing Address - Fax:
Practice Address - Street 1:11110 MEDICAL CAMPUS RD STE 125
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6799
Practice Address - Country:US
Practice Address - Phone:301-714-4335
Practice Address - Fax:301-714-4332
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDAC0056052086S0129X
VA0024186304363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery