Provider Demographics
NPI:1871368159
Name:BUNDREN, CHELSEA L (FNP-BC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:L
Last Name:BUNDREN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 PRESSMENS HOME RD
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-4146
Mailing Address - Country:US
Mailing Address - Phone:828-434-8534
Mailing Address - Fax:
Practice Address - Street 1:2104 PRESSMENS HOME RD
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857-4146
Practice Address - Country:US
Practice Address - Phone:828-434-8534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily