Provider Demographics
NPI:1871931683
Name:WILLETT, CHELSEY NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHELSEY
Middle Name:NICOLE
Last Name:WILLETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 MCCLAIN WAY
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-7010
Mailing Address - Country:US
Mailing Address - Phone:864-216-5872
Mailing Address - Fax:
Practice Address - Street 1:1751 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-2230
Practice Address - Country:US
Practice Address - Phone:864-573-5313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist