Provider Demographics
NPI:1710051065
Name:CHANCE, SANAE (CRNA)
Entity Type:Individual
Prefix:
First Name:SANAE
Middle Name:
Last Name:CHANCE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SANAE
Other - Middle Name:BROOKE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-0428
Mailing Address - Country:US
Mailing Address - Phone:570-386-2366
Mailing Address - Fax:570-386-3130
Practice Address - Street 1:1501 MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-2112
Practice Address - Country:US
Practice Address - Phone:610-527-1400
Practice Address - Fax:610-527-2775
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN278458L163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA022617PSSMedicare ID - Type Unspecified