Provider Demographics
NPI:1023495611
Name:MCCRONE, CHELSEA MARIAH (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIAH
Last Name:MCCRONE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 SYCAMORE AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-3352
Mailing Address - Country:US
Mailing Address - Phone:651-328-0666
Mailing Address - Fax:
Practice Address - Street 1:401 JAMES ST
Practice Address - Street 2:
Practice Address - City:VERDIGRE
Practice Address - State:NE
Practice Address - Zip Code:68783-6149
Practice Address - Country:US
Practice Address - Phone:402-668-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-03
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant