Healthcare Provider Details

I. General information

NPI: 1659109791
Provider Name (Legal Business Name): KAYLIN DAWN CHASE-HENLEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 02/26/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 US HIGHWAY 60
PANHANDLE TX
79068-7200
US

IV. Provider business mailing address

PO BOX 16
BUSHLAND TX
79012-0016
US

V. Phone/Fax

Practice location:
  • Phone: 806-532-2273
  • Fax: 806-532-2276
Mailing address:
  • Phone: 806-310-9855
  • Fax: 806-310-9857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP1169533
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: