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NPI Code Detail

MEDICARE: MS. RENEE KAREN CHASE MS-FNP

MEDICARE:  MS. RENEE KAREN CHASE  MS-FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerC-APM.0004578-C-NPCO
2363LF0000XFamily Nurse PractitionerAP3312AZ

General Provider Information

NPI Number : 1538301015
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RENEE KAREN CHASE MS-FNP
Provider Business Mailing Address
First Line : 41309 N BELFAIR WAY
Second Line :
City : ANTHEM
State : AZ
Zip : 85086-1232
Country : US
Telephone Number : 623-262-3993
Fax Number :
Provider Business Practice Location Address
First Line : 2145 E BASELINE RD STE 101
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1546
Country : US
Telephone Number : 480-353-2210
Fax Number : 480-776-0025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2009
Last Update Date : 05/26/2023

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