Provider Demographics
NPI:1174767719
Name:CHASE, STACEY LYNN TERPKO (PA)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:LYNN TERPKO
Last Name:CHASE
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:3330 CUMBERLAND BLVD SE STE 825
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-7009
Mailing Address - Country:US
Mailing Address - Phone:404-382-9941
Mailing Address - Fax:
Practice Address - Street 1:905 VERDAE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4098
Practice Address - Country:US
Practice Address - Phone:864-286-7550
Practice Address - Fax:864-286-7551
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2025-03-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC1793363A00000X
SCPA1793363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant