Individual
KAREN G CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP RN
Contact information
Practice address
3304 RENNER DR, FORTUNA, CA 95540-7102
(707) 725-4477
(707) 725-9209
Mailing address
670 9TH ST, SUITE 203, ARCATA, CA 95521-6248
(707) 826-8633
(707) 826-8638
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1101505
VA
363L00000X
Nurse Practitioner
4066P
KY
363L00000X
Nurse Practitioner
Primary
FNP22744
CA
363LF0000X
Family Nurse Practitioner
0024165295
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510227
—
TN
01
—
1891729406
NATIONAL PROVIDER IDENTIFICATION
CA
05
—
1891729406
—
VA
Enumeration date
07/10/2006
Last updated
08/22/2014
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