Individual
BRIAN CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
856 MAPLE ST, ROCKY HILL, CT 06067-1221
(203) 869-5765
Mailing address
67 HOLLY HILL LN, GREENWICH, CT 06830-6072
(203) 864-5515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8168
CT
363L00000X
Nurse Practitioner
Primary
RN259758
MA
363LA2100X
Acute Care Nurse Practitioner
8618
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8168
NURSE PRACTITIONER
CT
01
—
RN259758
NURSE PRACTITIONER
MA
Enumeration date
04/18/2019
Last updated
08/11/2020
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