Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 10036 | NC |
NPI | 1407238876 |
---|---|
Provider Name | Dr. Stephanie Ann Chapman |
First Address | Jefferson, NC 28640-0208 |
Second Address | Jefferson, NC 28640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2015 |
Last Update Date | 24/05/2021 |