Provider Demographics
NPI:1689784274
Name:CHANCE, BERNITA GALLAGHER (RNP)
Entity Type:Individual
Prefix:MRS
First Name:BERNITA
Middle Name:GALLAGHER
Last Name:CHANCE
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 132795
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77393-2795
Mailing Address - Country:US
Mailing Address - Phone:936-273-2016
Mailing Address - Fax:936-273-2018
Practice Address - Street 1:2928 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5247
Practice Address - Country:US
Practice Address - Phone:214-307-7786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX666037OtherLICENSE