Provider Demographics
NPI:1114227162
Name:CHASE, DIANE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:DR
Other - First Name:DIANE
Other - Middle Name:GABRIELLE
Other - Last Name:BERTRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1835 FRANKLIN ST
Mailing Address - Street 2:ST JOSEPH HOSPITAL ,
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218
Mailing Address - Country:US
Mailing Address - Phone:303-318-2292
Mailing Address - Fax:303-318-2288
Practice Address - Street 1:1835 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1126
Practice Address - Country:US
Practice Address - Phone:303-318-2292
Practice Address - Fax:303-318-2288
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0000686-NP363LF0000X
CO686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily