Provider Demographics
NPI:1689923104
Name:GINN, CHELSEA C (FNP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:C
Last Name:GINN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:M
Other - Last Name:COTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:1 HARNOIS AVE
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4392
Practice Address - Country:US
Practice Address - Phone:207-662-1340
Practice Address - Fax:207-662-1341
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP121066363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME003016402Medicare PIN
ME003016401Medicare PIN
MEP01122457Medicare PIN