Healthcare Provider Details

I. General information

NPI: 1700092822
Provider Name (Legal Business Name): HEATHER COLLIE CHASE MS,RN,IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 GREEN MOUNTAIN TPKE
CHESTER VT
05143-8321
US

IV. Provider business mailing address

1712 GREEN MOUNTAIN TPKE
CHESTER VT
05143-8321
US

V. Phone/Fax

Practice location:
  • Phone: 802-875-5683
  • Fax: 802-875-6544
Mailing address:
  • Phone: 802-875-5683
  • Fax: 802-875-6544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26.0029480
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number26.0029480
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number0260029480
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: