Provider Demographics
NPI:1043807811
Name:CHAPMAN, AMY CARPENTER
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CARPENTER
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:BROOKE
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 S BUCKOAK ST
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-1960
Mailing Address - Country:US
Mailing Address - Phone:704-718-7149
Mailing Address - Fax:
Practice Address - Street 1:425 S BUCKOAK ST
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:NC
Practice Address - Zip Code:28164-1960
Practice Address - Country:US
Practice Address - Phone:704-718-7149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC286342163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice