Provider Demographics
NPI:1003122904
Name:CHAPMAN, HOLLY KATHLEEN (AA, BA,)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:KATHLEEN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:AA, BA,
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:KATHLEEN
Other - Last Name:GLEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1483 W NORTH BEAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-1451
Mailing Address - Country:US
Mailing Address - Phone:209-384-2619
Mailing Address - Fax:
Practice Address - Street 1:100 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-0510
Practice Address - Country:US
Practice Address - Phone:209-550-5869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program