Healthcare Provider Details

I. General information

NPI: 1790213908
Provider Name (Legal Business Name): CHELSEA DAWN OUELLETTE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CHELSEA DAWN HEBERT

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 07/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PIKES HL
NORWAY ME
04268-5340
US

IV. Provider business mailing address

87 AMBERLEY WAY
AUBURN ME
04210-4377
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-7721
  • Fax:
Mailing address:
  • Phone: 207-689-5191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN64845
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP171050
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: