Provider Demographics
NPI:1043958408
Name:CHAPMAN, KENNETH R JR
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:R
Last Name:CHAPMAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:KENNETH
Other - Middle Name:R
Other - Last Name:CHAPMAN
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:108 ARBOR GLEN CT
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-7228
Mailing Address - Country:US
Mailing Address - Phone:702-677-1850
Mailing Address - Fax:
Practice Address - Street 1:108 ARBOR GLEN CT
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-7228
Practice Address - Country:US
Practice Address - Phone:702-677-1850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN375792163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse