Healthcare Provider Details

I. General information

NPI: 1821404872
Provider Name (Legal Business Name): RAQUEL ERICA CHADWICK RN, MS, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RAQUEL ERICA SULLY NP

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 RESEARCH PL SUITE 320
NORTH CHELMSFORD MA
01863-2454
US

IV. Provider business mailing address

20 RESEARCH PL SUITE 320
NORTH CHELMSFORD MA
01863-2454
US

V. Phone/Fax

Practice location:
  • Phone: 978-256-1858
  • Fax: 978-788-7890
Mailing address:
  • Phone: 978-256-1858
  • Fax: 978-788-7890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN2266761
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: