Provider Demographics
NPI:1205218724
Name:CHASE, STEFFEN DANIEL (FNP-BC)
Entity Type:Individual
Prefix:
First Name:STEFFEN
Middle Name:DANIEL
Last Name:CHASE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BROAD ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4263
Mailing Address - Country:US
Mailing Address - Phone:423-239-9737
Mailing Address - Fax:
Practice Address - Street 1:1990 HOLTON AVE E
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-3350
Practice Address - Country:US
Practice Address - Phone:276-523-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-20
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172702363LF0000X
TN170644163WC0200X
TN20091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine