Provider Demographics
NPI:1174984884
Name:MATLEY, CHELSEA L (RN, CCP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:L
Last Name:MATLEY
Suffix:
Gender:F
Credentials:RN, CCP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:L
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CCP
Mailing Address - Street 1:N46W28576 WILLOW BROOK CT
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-2290
Mailing Address - Country:US
Mailing Address - Phone:262-505-0920
Mailing Address - Fax:
Practice Address - Street 1:N46W28576 WILLOW BROOK CT
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-2290
Practice Address - Country:US
Practice Address - Phone:262-505-0920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI222983163WP0200X, 163WH0200X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health