Provider Demographics
NPI:1174355457
Name:DICKERSON, CHELSEA MARIE (MSN APRN PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:DICKERSON
Suffix:
Gender:F
Credentials:MSN APRN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 CRAIG CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-5612
Mailing Address - Country:US
Mailing Address - Phone:513-675-6469
Mailing Address - Fax:
Practice Address - Street 1:9049 SPRINGBORO PIKE
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-4926
Practice Address - Country:US
Practice Address - Phone:937-759-0545
Practice Address - Fax:937-759-0549
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0037322363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health