Individual
TAMMY CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
12800 MISSISSIPPI PKWY STE B100, CROWN POINT, IN 46307-6901
(219) 662-5700
(219) 662-2569
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71005859A
IN
363LF0000X
Family Nurse Practitioner
71005859A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201329270
—
IN
Enumeration date
10/14/2015
Last updated
04/14/2023
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