Provider Demographics
NPI:1619459906
Name:FLECK, CHELSEA A (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:A
Last Name:FLECK
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:FRITZSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:119 BELMONT STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2903
Practice Address - Country:US
Practice Address - Phone:508-334-8706
Practice Address - Fax:508-793-6849
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN10015440363L00000X
COAPN.0997416-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000204695Medicaid