Provider Demographics
NPI:1821404872
Name:CHADWICK, RAQUEL ERICA (RN, MS, WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:ERICA
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:RN, MS, WHNP-BC
Other - Prefix:MS
Other - First Name:RAQUEL
Other - Middle Name:ERICA
Other - Last Name:SULLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:20 RESEARCH PL
Mailing Address - Street 2:SUITE 320
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2454
Mailing Address - Country:US
Mailing Address - Phone:978-256-1858
Mailing Address - Fax:978-788-7890
Practice Address - Street 1:20 RESEARCH PL
Practice Address - Street 2:SUITE 320
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2454
Practice Address - Country:US
Practice Address - Phone:978-256-1858
Practice Address - Fax:978-788-7890
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266761363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology