Chase, Tia Marie

Chase, Tia Marie is an individual health care provider with primary practice located at 111 4Th St Se , Huron SD 57350-2509. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Chase, Tia Marie can be contacted via phone (605) 352-8691.

Contact Information

Primary practice address
111 4Th St Se Huron SD 57350-2509
Fax: (605) 352-8704
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1124 South Dakota

Profile Details

NPI number 1861904476
LBN Legal business name Chase, Tia Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2017
Last updated Jan 25th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861904476 NPPES
South Dakota MEDICAID 2015122

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