Individual
CHELSEA NICOLE LAGRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 333-2663
(812) 676-4131
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085005666
IL
363A00000X
Physician Assistant
Primary
10003588A
IN
Other
Enumeration date
08/28/2015
Last updated
05/18/2022
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