Provider Demographics
NPI:1235657040
Name:CHASE, CHRISTY (DNP, APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MOUNT CARMEL AVENUE
Mailing Address - Street 2:QUINNIPIAC UNIVERSITY, STUDENT HEALTH SERVICES
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1961
Mailing Address - Country:US
Mailing Address - Phone:203-582-8738
Mailing Address - Fax:203-582-8924
Practice Address - Street 1:275 MOUNT CARMEL AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1961
Practice Address - Country:US
Practice Address - Phone:203-582-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7199363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner