Provider Demographics
NPI:1114635729
Name:CHAPA, EMERY JUSTINE (NP)
Entity Type:Individual
Prefix:MRS
First Name:EMERY
Middle Name:JUSTINE
Last Name:CHAPA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EMERY
Other - Middle Name:JUSTINE
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3701 BASTROP ST
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-1401
Mailing Address - Country:US
Mailing Address - Phone:469-634-6668
Mailing Address - Fax:
Practice Address - Street 1:2222 W PARKSIDE LN STE 114
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1260
Practice Address - Country:US
Practice Address - Phone:469-634-6668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ300795363LP0808X
TX1098777363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health