Provider Demographics
NPI:1013240571
Name:CHASE, HEATHER TOLMAN (NP-C)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:TOLMAN
Last Name:CHASE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:CHASE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:96 CAMPUS DR
Practice Address - Street 2:SUITE 1
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7163
Practice Address - Country:US
Practice Address - Phone:207-885-9905
Practice Address - Fax:207-396-5600
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP091046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1013240571Medicaid