Provider Demographics
NPI:1265003826
Name:GARDNER, CHELSEA ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:ANN
Last Name:GARDNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ANN
Other - Last Name:SONDAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:85 BARNES RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1832
Mailing Address - Country:US
Mailing Address - Phone:203-309-0070
Mailing Address - Fax:203-309-0071
Practice Address - Street 1:85 BARNES ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-309-0070
Practice Address - Fax:203-309-0071
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9776207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine