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NPI Code Detail

MEDICARE: SALLY A CHAPDELAINE RNCS

MEDICARE: SALLY A CHAPDELAINE RNCS
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
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse90997MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1708151OTHERMATUFTS HEALTH PLAN
2PN0015OTHERMABCBSMA

General Provider Information

NPI Number : 1760593792
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY A CHAPDELAINE RNCS
Provider Business Mailing Address
First Line : 5 PASTURE RD
Second Line :
City : ROCKPORT
State : MA
Zip : 01966-1321
Country : US
Telephone Number : 987-546-3073
Fax Number : 978-546-2045
Provider Business Practice Location Address
First Line : 5 PASTURE RD
Second Line :
City : ROCKPORT
State : MA
Zip : 01966-1321
Country : US
Telephone Number : 987-546-3073
Fax Number : 978-546-2045
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 04/21/2008

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Directions to “ SALLY A CHAPDELAINE RNCS” Practice Location

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