Individual
JASON ROBERT CHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-BC
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
Mailing address
5117 FROST FLOWER LN, LAFAYETTE, IN 47909-9077
(765) 637-3705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71014577A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300085276
—
IN
Enumeration date
01/08/2024
Last updated
02/01/2024
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