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General NPI Number Information
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NPI Number | 1497396543
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Entity Type | Individual
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Provider Name | DAWN MELISSA CHASE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 67 EUSTIS PKWY
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City | WATERVILLE
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State | ME
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Zip | 04901-5173
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Country | US
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Telephone | 207-873-2136
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Fax | 207-660-4529
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Provider Business Mailing Address
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Address Line | 66 CEMETERY RD
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City | MONMOUTH
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State | ME
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Zip | 04259-7632
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Country | US
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Telephone | 207-754-9320
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R044470
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP191282
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License Number State | ME
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