Basic Information
Provider Information
NPI: 1780261438
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: HARLEY
MiddleName: E
NamePrefix: MR.
NameSuffix: JR.
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 E MCBEE AVE FL 4
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296012842
CountryCode: US
TelephoneNumber: 8034341335
FaxNumber:  
Practice Location
Address1: 298 MEMORIAL DR
Address2:  
City: SENECA
State: SC
PostalCode: 296729443
CountryCode: US
TelephoneNumber: 8648857101
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/27/2021
LastUpdateDate: 06/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X99699SCN Nursing Service ProvidersRegistered Nurse 
363L00000X24869SCN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
207P00000X24869SCY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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