Provider Demographics
NPI:1336511062
Name:CHAPMAN, STACY (BA)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 N DUPRE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2108
Mailing Address - Country:US
Mailing Address - Phone:504-220-7375
Mailing Address - Fax:504-340-8884
Practice Address - Street 1:1722 N DUPRE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119
Practice Address - Country:US
Practice Address - Phone:504-220-7375
Practice Address - Fax:504-340-8884
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator