Provider Demographics
NPI:1487799516
Name:CHASE, JEANNE A (FNP)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:A
Last Name:CHASE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:107 METKER TRL
Mailing Address - Street 2:SUITE A
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-1049
Mailing Address - Country:US
Mailing Address - Phone:606-365-8338
Mailing Address - Fax:606-365-8142
Practice Address - Street 1:107 METKER TRL
Practice Address - Street 2:SUITE A
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-1049
Practice Address - Country:US
Practice Address - Phone:606-365-8338
Practice Address - Fax:606-365-8142
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY2918P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78005998Medicaid
P39420Medicare UPIN
KY78005998Medicaid