Basic Information
| Provider Information | |||||||||
| NPI: | 1710341201 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAJDALANY | ||||||||
| FirstName: | CHELSEA | ||||||||
| MiddleName: | IRENE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GOODSON | ||||||||
| OtherFirstName: | CHELSEA | ||||||||
| OtherMiddleName: | IRENE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1985 WASHINGTON PARK LN | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300333336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346603470 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1500 EAST MEDICAL CENTER DR | ||||||||
| Address2: | 3RD FLOOR CARDIOVASCULAR CENTER RECP C | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8882871082 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2016 | ||||||||
| LastUpdateDate: | 05/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 4704253369 | MI | N | Nursing Service Providers | Registered Nurse | 163W00000X | RN282910 | GA | N | Nursing Service Providers | Registered Nurse | 363L00000X | 4704253369 | MI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | RN282910 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.