Healthcare Provider Details

I. General information

NPI: 1053047738
Provider Name (Legal Business Name): HELEN CHAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 BEDFORD ST STE 130
LEXINGTON MA
02420-4543
US

IV. Provider business mailing address

57 BEDFORD ST STE 130
LEXINGTON MA
02420-4543
US

V. Phone/Fax

Practice location:
  • Phone: 857-264-0977
  • Fax: 781-862-5500
Mailing address:
  • Phone: 781-862-7500
  • Fax: 781-862-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2348444
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN69315
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: