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KAREN G CHASE FNP RN

>> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1891729406

Individual Registrant:
 KAREN G CHASE FNP RN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3304 RENNER DR  FORTUNA, CA 95540-7102 US
Tel: 707-725-4477  Fax: 707-725-9209

Contact information for business:
670 9TH ST SUITE 203 ARCATA, CA 95521-6248 US
Tel: 707-826-8633  Fax: 707-826-8638

Registration Information:
NPI: 1891729406
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N163W00000XNursing Service Providers
Registered Nurse
VA1101505
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
KY4066P
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
VA0024165295
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
CAFNP22744

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
NATIONAL PROVIDER IDENTIFICATION1891729406CA01
1891729406VA05
1510227TN05




HEALTH CARE JOBS CA - Page 1



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