Provider Demographics
NPI:1578810669
Name:EMMONS, CHELSY ROSE (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:CHELSY
Middle Name:ROSE
Last Name:EMMONS
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:MS
Other - First Name:CHELSY
Other - Middle Name:ROSE
Other - Last Name:JUNGBLUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:2525 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4518
Mailing Address - Country:US
Mailing Address - Phone:612-813-7491
Mailing Address - Fax:612-813-6360
Practice Address - Street 1:2530 CHICAGO AVE
Practice Address - Street 2:MAIL STOP 560
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4289
Practice Address - Country:US
Practice Address - Phone:612-813-6271
Practice Address - Fax:612-813-6360
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
MN1049170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS