Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R069415 | MD |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R069415 | MD |
NPI | 1023100120 |
---|---|
Provider Name | Cathy S Chapman |
First Address | Lavale, MD 21502-7325 |
Second Address | Lavale, MD 21502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 16/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
329444700 | (05) | MD |
9600036000 | (05) | WV |
MC0206513 | DEA REGISTRATION (01) | |
S24767 | (02) | MD |