Provider Demographics
NPI:1174827133
Name:CHAPMAN, MELANIE SUSAN (ARNP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:SUSAN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:SUSAN
Other - Last Name:CRISP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:607 OLD STEESE HWY STE B307
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3163
Mailing Address - Country:US
Mailing Address - Phone:907-452-1761
Mailing Address - Fax:844-635-0016
Practice Address - Street 1:1405 KELLUM ST STE 201
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4189
Practice Address - Country:US
Practice Address - Phone:907-452-1761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9283382363LF0000X
IL209008933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59-2420282OtherTAX ID
AK1713806Medicaid