Provider Demographics
NPI:1871969535
Name:LE, CHAU BAO THI (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:CHAU
Middle Name:BAO THI
Last Name:LE
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1780
Mailing Address - Country:US
Mailing Address - Phone:978-251-3159
Mailing Address - Fax:978-251-0636
Practice Address - Street 1:10 ADAMS ST
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1780
Practice Address - Country:US
Practice Address - Phone:978-251-3159
Practice Address - Fax:978-251-0636
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2280658363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care