Healthcare Provider Details

I. General information

NPI: 1295185882
Provider Name (Legal Business Name): KAREN M. CHASE APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN MAY DEGROFT

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 E BROAD ST
PATASKALA OH
43062-7627
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-685-2805
  • Fax: 614-293-1783
Mailing address:
  • Phone: 614-685-2805
  • Fax: 614-293-1783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704271180
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0036498
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4017769
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704271180
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0036498
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: