Provider Demographics
NPI:1821254038
Name:TRICE, CHANTAL E (CRNP)
Entity Type:Individual
Prefix:
First Name:CHANTAL
Middle Name:E
Last Name:TRICE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CHANTAL
Other - Middle Name:E
Other - Last Name:SAXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:520 JEFFERSON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-527-8060
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:530 SOUTH ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2775
Practice Address - Country:US
Practice Address - Phone:724-689-1354
Practice Address - Fax:724-689-0543
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA535978OtherMEDICARE GROUP NO.
PA137923Medicare PIN