Healthcare Provider Details

I. General information

NPI: 1306362025
Provider Name (Legal Business Name): JODY ANN CHANCE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10243 ROGERS DR
NASSAWADOX VA
23413-1016
US

IV. Provider business mailing address

26 KERR ST
ONANCOCK VA
23417-4206
US

V. Phone/Fax

Practice location:
  • Phone: 757-571-9750
  • Fax: 757-241-5990
Mailing address:
  • Phone: 804-399-8175
  • Fax: 757-241-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024175223
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: