Provider Demographics
NPI:1942232665
Name:CHANCE, KAREN HARRIS (NP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:HARRIS
Last Name:CHANCE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:924 N HOWE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-3038
Mailing Address - Country:US
Mailing Address - Phone:910-772-9202
Mailing Address - Fax:866-345-8963
Practice Address - Street 1:4222 LONG BEACH RD SE
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8627
Practice Address - Country:US
Practice Address - Phone:910-341-3300
Practice Address - Fax:910-251-8824
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC01439363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2592675Medicare PIN