Provider Demographics
NPI:1316231392
Name:CHASE, CARRIE ANN (CRNP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:CHASE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:POORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:615 STEEPLE CHASE LN
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-0529
Mailing Address - Country:US
Mailing Address - Phone:202-365-4752
Mailing Address - Fax:
Practice Address - Street 1:615 STEEPLE CHASE LN
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-0529
Practice Address - Country:US
Practice Address - Phone:202-365-4752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN67240-NP-C363LF0000X
VA0024172548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily