Provider Demographics
NPI:1013361088
Name:CHAPMAN, JENNIFER COLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:COLE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MCCRACKEN
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:518 SUNSHINE LN
Mailing Address - Street 2:
Mailing Address - City:KIMPER
Mailing Address - State:KY
Mailing Address - Zip Code:41539-6449
Mailing Address - Country:US
Mailing Address - Phone:606-631-3174
Mailing Address - Fax:
Practice Address - Street 1:60 PHILLIPS BRANCH RD
Practice Address - Street 2:
Practice Address - City:PHELPS
Practice Address - State:KY
Practice Address - Zip Code:41553-9061
Practice Address - Country:US
Practice Address - Phone:606-456-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist