Provider Demographics
NPI:1114525714
Name:CHAPMAN, COURTNEY LYNAE (FNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LYNAE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 KENYON AVE NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-9552
Mailing Address - Country:US
Mailing Address - Phone:330-904-9626
Mailing Address - Fax:
Practice Address - Street 1:3838 KENYON AVE NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-9552
Practice Address - Country:US
Practice Address - Phone:330-904-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.420781163W00000X
OHAPRN.CNP.0027254363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse