Individual
DIANE E CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
(617) 421-6084
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
98129
MA
363LA2200X
Adult Health Nurse Practitioner
98129
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0357464
—
MA
01
—
N619
HARVARD PILGRIM
MA
01
—
NP1559
BLUE CROSS
MA
Enumeration date
03/17/2006
Last updated
05/31/2013
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