| Doctor Name: | NICOLE CHASE |
| NPI Number: | 1467560540 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | AP081789 |
| Business Practice Address: | 111 Ossipee Trl E Suite 1142 Standish, ME - 040846464 |
| Business Phone Number: | 2076424434 |
| Business Fax Number: | 2076424439 |
| Mailing Address: | 144 State St, PORTLAND |
| State: | ME |
| Postal Code: | 041013776 |
| Phone Number: | 2078793470 |
| Fax Number: | 2078793153 |
| NPI Enumeration Date: | 08/28/2006 |
| NPI Last Update Date: | 04/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP081789 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |