Provider Demographics
NPI:1235846544
Name:CHASE, SHINA REI-ANN (NP)
Entity Type:Individual
Prefix:
First Name:SHINA
Middle Name:REI-ANN
Last Name:CHASE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 S 4TH ST APT 108
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-2206
Mailing Address - Country:US
Mailing Address - Phone:786-222-4784
Mailing Address - Fax:
Practice Address - Street 1:511 S 4TH ST APT 108
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-2206
Practice Address - Country:US
Practice Address - Phone:786-222-4784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015791363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care