Provider Demographics
NPI:1144732520
Name:CHANCE, KASEY DUFFIE (FNP-C)
Entity type:Individual
Prefix:DR
First Name:KASEY
Middle Name:DUFFIE
Last Name:CHANCE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:KASEY
Other - Middle Name:MARIE
Other - Last Name:DUFFIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 BRUSHFIRE DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-7069
Mailing Address - Country:US
Mailing Address - Phone:334-465-1103
Mailing Address - Fax:
Practice Address - Street 1:211 BRUSHFIRE DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-7069
Practice Address - Country:US
Practice Address - Phone:334-465-1103
Practice Address - Fax:334-465-1103
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-139071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily