Individual
CHELSEA AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
107 KOONTZ AVE STE 200, CLENDENIN, WV 25045-9581
(304) 548-7272
Mailing address
104 ALEX LN, CHARLESTON, WV 25304-2952
(304) 734-2040
(304) 734-2047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2825
WV
363A00000X
Physician Assistant
PA9108790
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
272810084
TAX ID
FL
Enumeration date
07/09/2015
Last updated
01/10/2024
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