Healthcare Provider Details

I. General information

NPI: 1821391947
Provider Name (Legal Business Name): COURTNEY WELLS CHARTRAND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2010
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 GLEN RIDGE CT
PONTE VEDRA FL
32081-8332
US

IV. Provider business mailing address

46 GLEN RIDGE CT
PONTE VEDRA FL
32081-8332
US

V. Phone/Fax

Practice location:
  • Phone: 617-869-3534
  • Fax:
Mailing address:
  • Phone: 617-869-3534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN255000
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP141070
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN948970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: