Provider Demographics
NPI:1992021687
Name:CHASANOV, CARYN BROWN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:BROWN
Last Name:CHASANOV
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34381 CARPENTERS WAY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4910
Mailing Address - Country:US
Mailing Address - Phone:302-644-7201
Mailing Address - Fax:302-644-7218
Practice Address - Street 1:34381 CARPENTERS WAY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4910
Practice Address - Country:US
Practice Address - Phone:302-644-7201
Practice Address - Fax:302-644-7218
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily