Provider Demographics
NPI:1265050272
Name:PATERSON, CHELSEA NICOLE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:NICOLE
Last Name:PATERSON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CONGRESS ST STE B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2153
Mailing Address - Country:US
Mailing Address - Phone:207-774-5222
Mailing Address - Fax:
Practice Address - Street 1:240 N BROADWAY STE 208
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1881
Practice Address - Country:US
Practice Address - Phone:503-664-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID75864363L00000X
UT13229678-4405363L00000X
MECNP201265363L00000X, 363LF0000X
WAAP61403919363L00000X
OR10004944363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily