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KAREN G CHASE FNP RN
>> Registered Nurse >> Nursing Service ProvidersRegistrant NPI Number: 1891729406
Individual Registrant: KAREN G CHASE FNP RN
Gender: F
Not Sole Proprietor
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
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
Tel: 707-826-8633 Fax: 707-826-8638
Registration Information:
NPI: 1891729406
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 163W00000X | Nursing Service Providers Registered Nurse | VA | 1101505 |
| N | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | KY | 4066P |
| N | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | VA | 0024165295 |
| Y | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | CA | FNP22744 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| NATIONAL PROVIDER IDENTIFICATION | 1891729406 | CA | 01 |
| 1891729406 | VA | 05 | |
| 1510227 | TN | 05 |
