Provider Demographics
NPI:1629024831
Name:CHASE, KRISTEN (CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:TAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:10 ORMS ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-2228
Mailing Address - Country:US
Mailing Address - Phone:401-453-0666
Mailing Address - Fax:401-453-9619
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:DEPT OF ANESTHESIA
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-2284
Practice Address - Fax:401-444-5083
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRNA28298367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered