Basic Information
Provider Information
NPI: 1134403488
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: JULIE ANNE
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2147
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339022147
CountryCode: US
TelephoneNumber: 2394241449
FaxNumber: 2394241421
Practice Location
Address1: 13279 N CLEVELAND AVE
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339034818
CountryCode: US
TelephoneNumber: 2396524111
FaxNumber: 2396524105
Other Information
ProviderEnumerationDate: 10/05/2011
LastUpdateDate: 12/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XARNP9240114FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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