MEDICARE: CHAOS AND CLARITY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1871466466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAOS AND CLARITY PLLC

Provider Business Mailing Address
First Line	:	34125 US HIGHWAY 19 N STE 200
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-2115
Country	:	US
Telephone Number	:	728-214-9099
Fax Number	:

Provider Business Practice Location Address
First Line	:	34125 US HIGHWAY 19 N STE 200
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-2115
Country	:	US
Telephone Number	:	728-214-9099
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	BRENDAN KEANY
Credential	:
Telephone Number	:	728-214-9099

Provider Enumeration Date	:	09/29/2025
Last Update Date	:	12/08/2025

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