Healthcare Provider Details

I. General information

NPI: 1629419536
Provider Name (Legal Business Name): CHELSIE M MCCARTHY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 MAIN ST
ACTON MA
01720
US

IV. Provider business mailing address

321 MAIN ST
ACTON MA
01720-3799
US

V. Phone/Fax

Practice location:
  • Phone: 978-635-8700
  • Fax:
Mailing address:
  • Phone: 978-635-8700
  • Fax: 212-746-8387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number656914
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number338553
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: