Chelsea C Clark, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

026.0086622 Issued in VT

Practice address

15 East Rd Unit 102
Fairfax, VT 05454-4450

Phone

(802) 363-3297

NPI assigned

Nov 22, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1578891040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EAST RD UNIT 102",
            "city": "FAIRFAX",
            "state": "VT",
            "postal_code": "054544450",
            "telephone_number": "802-363-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 EAST RD UNIT 102",
            "city": "FAIRFAX",
            "state": "VT",
            "postal_code": "054544450",
            "telephone_number": "802-363-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHELSEA",
        "middle_name": "C",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-22",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VT",
            "license": "026.0086622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tristin Adie, FNP
• Christina HR Allard, PT
• Joseph Matthew Boone, NP-C
• Kaitlin E Brenny, PA-C
• Susie Elizabeth Caron, M.A.
• Maxwell Crystal
• Sherry Lynne Cushing
• Casey D'Alberto, DPT
• Sarah Desilvey, FNP
• Jacqueline F Esancy, LADC, LCMHC, LPC

• All providers in Fairfax, VT
• Lactation Consultant (Registered Nurse) in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.