Provider Demographics
NPI:1225707144
Name:CHAPA, TASHA (ARNP)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:
Last Name:CHAPA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4597 CREEKVIEW TRL
Mailing Address - Street 2:
Mailing Address - City:PALO
Mailing Address - State:IA
Mailing Address - Zip Code:52324-5703
Mailing Address - Country:US
Mailing Address - Phone:641-799-2772
Mailing Address - Fax:
Practice Address - Street 1:4597 CREEKVIEW TRL
Practice Address - Street 2:
Practice Address - City:PALO
Practice Address - State:IA
Practice Address - Zip Code:52324-5703
Practice Address - Country:US
Practice Address - Phone:641-799-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA165548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily