Basic Information
Provider Information
NPI: 1760645741
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: RACHEL
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CHAPMAN
OtherFirstName: RACHEL
OtherMiddleName: M.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: P.O. BOX 173862
Address2:  
City: DENVER
State: CO
PostalCode: 802173862
CountryCode: US
TelephoneNumber: 3033067783
FaxNumber: 3033067753
Practice Location
Address1: 9191 GRANT STREET
Address2:  
City: THORNTON
State: CO
PostalCode: 802298812
CountryCode: US
TelephoneNumber: 3034504482
FaxNumber: 3033067753
Other Information
ProviderEnumerationDate: 07/09/2008
LastUpdateDate: 09/10/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X449649PAN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X48085AZN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XDR.0055318COY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
6632781405CO MEDICAID


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