Provider Demographics
NPI:1851848154
Name:MCGOVERN, CHELSEA (MSN, RN, AGNP-C)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:MCGOVERN
Suffix:
Gender:F
Credentials:MSN, RN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W MONROE ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-2420
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:773-866-8014
Practice Address - Street 1:712 BROAD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1465
Practice Address - Country:US
Practice Address - Phone:401-233-5060
Practice Address - Fax:401-372-2618
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01456363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care