Provider Demographics
NPI:1114685666
Name:CHAPMAN, DIANA KISIEL (PMHNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:KISIEL
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4216
Mailing Address - Country:US
Mailing Address - Phone:520-250-4508
Mailing Address - Fax:
Practice Address - Street 1:3250 E 3RD ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4216
Practice Address - Country:US
Practice Address - Phone:520-250-4508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ265623363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health