Basic Information
| Provider Information | |||||||||
| NPI: | 1770547556 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHABEK | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | FRANCINE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CRNA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | NAGLE | ||||||||
| OtherFirstName: | NANCY | ||||||||
| OtherMiddleName: | FRANCINE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CRNA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 800 N FANT ST | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296215708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645121417 | ||||||||
| FaxNumber: | 8645121896 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 N FANT ST | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296215708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645121340 | ||||||||
| FaxNumber: | 8645121749 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2006 | ||||||||
| LastUpdateDate: | 12/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 1633 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 30090979 | 01 | SC | SELECT HEALTH | OTHER | 511I430163 | 01 | GA | MEDICARE | OTHER | 898612058B | 05 | GA | MEDICAID | AN1114 | 05 | SC | MEDICAID | P00251281 | 01 | GA | RAILROAD MEDICARE | OTHER | NPI # | 01 | SC | ABSOLUTE TOTAL CARE | OTHER | NPI # / SSN# | 01 | SC | TRICARE | OTHER | 1770547556 | 01 | SC | BLUE CROSS BLUE SHIELD OF SC | OTHER | 414933 | 01 | SC | UNISON | OTHER |