Healthcare Provider Details

I. General information

NPI: 1942891007
Provider Name (Legal Business Name): COURTNEY NICOLE CHANCE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY N HARGUS

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 E GRAND ST
SPRINGFIELD MO
65807-1447
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 417-761-5600
  • Fax: 417-761-5601
Mailing address:
  • Phone: 417-761-5214
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2015004280
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2021003903
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: