Provider Demographics
NPI:1790213908
Name:OUELLETTE, CHELSEA DAWN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:DAWN
Last Name:OUELLETTE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:DAWN
Other - Last Name:HEBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:87 AMBERLEY WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-4377
Mailing Address - Country:US
Mailing Address - Phone:207-689-5191
Mailing Address - Fax:
Practice Address - Street 1:8 PIKES HL
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5340
Practice Address - Country:US
Practice Address - Phone:207-743-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN64845163W00000X
MECNP171050363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse