Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 2005024857 | MO |
NPI | 1144602087 |
---|---|
Provider Name | Mrs. Ashley Chapman |
First Address | Springfield, MO 65804-2203 |
Second Address | Springfield, MO 65804-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2015 |
Last Update Date | 28/06/2015 |