MEDICARE: CHELSAE ANNE NUGENT

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
1	363LW0102X	Women's Health Nurse Practitioner	3008614	KY
2	390200000X	Student in an Organized Health Care Education/Training Program

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	192860004	OTHER	IN	MEDICARE IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396159505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSAE ANNE NUGENT

Provider Business Mailing Address
First Line	:	PO BOX 94670
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73143-4670
Country	:	US
Telephone Number	:	405-682-3303
Fax Number	:	405-793-8993

Provider Business Practice Location Address
First Line	:	500 S PRESTON ST RM 305
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1702
Country	:	US
Telephone Number	:	502-548-9475
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2014
Last Update Date	:	11/03/2024

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Directions to “ CHELSAE ANNE NUGENT ” Practice Location

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