Doctor Name: | KATLYN M. CHACE |
NPI Number: | 1508249772 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DNP |
License Number: | 19591 |
Business Practice Address: | 1254 Yeamans Hall Rd Hanahan, SC - 294102787 |
Business Phone Number: | 8435548312 |
Business Fax Number: | 8435545141 |
Mailing Address: | Po Box 118008, NORTH CHARLESTON |
State: | SC |
Postal Code: | 294238008 |
Phone Number: | 8435727727 |
Fax Number: | 8435695895 |
NPI Enumeration Date: | 07/07/2015 |
NPI Last Update Date: | 09/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 19591 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |