Basic Information
| Provider Information | |||||||||
| NPI: | 1396159505 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NUGENT | ||||||||
| FirstName: | CHELSAE | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | WHNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 94670 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731434670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056823303 | ||||||||
| FaxNumber: | 4057938993 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 GORDON GUTMANN BLVD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | JEFFERSONVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471303764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122826114 | ||||||||
| FaxNumber: | 8122802142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2014 | ||||||||
| LastUpdateDate: | 04/05/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | 3008614 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 201260470A | 05 | IN | MEDICAID | 192860004 | 01 | IN | MEDICARE IN | OTHER |