Provider Demographics
NPI:1295203289
Name:GALLAGHER, CHELSEA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1738
Mailing Address - Country:US
Mailing Address - Phone:860-309-7393
Mailing Address - Fax:
Practice Address - Street 1:26 EDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1738
Practice Address - Country:US
Practice Address - Phone:860-309-7393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily