Provider Demographics
NPI:1972659365
Name:CHASE, STACY N (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:N
Last Name:CHASE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:ROLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3476
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36831-3476
Mailing Address - Country:US
Mailing Address - Phone:334-844-4416
Mailing Address - Fax:334-844-6126
Practice Address - Street 1:400 LEM MORRISON DR
Practice Address - Street 2:
Practice Address - City:AUBURN UNIVERSITY
Practice Address - State:AL
Practice Address - Zip Code:36849-0001
Practice Address - Country:US
Practice Address - Phone:334-844-4416
Practice Address - Fax:334-844-6126
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-061580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily