Provider Demographics
NPI:1982241444
Name:CHEN, QIMIN (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:QIMIN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13636 39TH AVE
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5576
Mailing Address - Country:US
Mailing Address - Phone:718-353-6611
Mailing Address - Fax:
Practice Address - Street 1:13636 39TH AVE
Practice Address - Street 2:7TH FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5576
Practice Address - Country:US
Practice Address - Phone:718-353-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345199363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily