Provider Demographics
NPI:1477613990
Name:CHAPMAN, VICKIE W (NP)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:W
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:105 JW PLAZA DR SE STE 1
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-1503
Mailing Address - Country:US
Mailing Address - Phone:706-383-5622
Mailing Address - Fax:833-884-0475
Practice Address - Street 1:1105 BURLEYSON RD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3181
Practice Address - Country:US
Practice Address - Phone:706-278-4640
Practice Address - Fax:706-275-6599
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN066554 NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA823455973BMedicaid