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General NPI Number Information
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NPI Number | 1982560611
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Entity Type | Individual
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Provider Name | CHACE NACKE
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Gender |
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 367 W OAK HILL RD
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City | MOUNT DORA
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State | FL
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Zip | 32757-4639
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Country | US
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Telephone | 352-409-7944
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Fax |
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Provider Business Mailing Address
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Address Line | 367 W OAK HILL RD
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City | MOUNT DORA
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State | FL
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Zip | 32757-4639
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11044380
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License Number State | FL
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