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NPI Code Detail

MEDICARE: MISS CHELSEA LEE GAGNE FNP-C

MEDICARE: MISS CHELSEA LEE GAGNE FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF10220376MA

General Provider Information

NPI Number : 1104541432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CHELSEA LEE GAGNE FNP-C
Provider Business Mailing Address
First Line : 350 RIVERBEND ST UNIT 6
Second Line :
City : ATHOL
State : MA
Zip : 01331-2542
Country : US
Telephone Number : 978-467-7002
Fax Number :
Provider Business Practice Location Address
First Line : 57 CITY HALL AVE
Second Line :
City : GARDNER
State : MA
Zip : 01440-2614
Country : US
Telephone Number : 978-630-3862
Fax Number : 978-630-4176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2022
Last Update Date : 10/10/2022

Similar Medicare Providers

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1962577262 — MR. MATTHEW J ENOS PA
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1730225582 — DR. JEFFREY D MOSER D.P.M.
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1003011594 — GARDNER FAMILY MEDICINE, INC.
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1992201925 — ERIK WILLIAM WISNIEWSKI FNP
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Directions to “ MISS CHELSEA LEE GAGNE FNP-C” Practice Location

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