Provider Demographics
NPI:1518251974
Name:CHAPMAN, DIANNE E (RPH)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:E
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 SOUTHPARK BLVD
Mailing Address - Street 2:TARGET 1016
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-3606
Mailing Address - Country:US
Mailing Address - Phone:804-520-2280
Mailing Address - Fax:804-520-2280
Practice Address - Street 1:721 SOUTHPARK BLVD
Practice Address - Street 2:TARGET 1016
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3606
Practice Address - Country:US
Practice Address - Phone:804-520-2280
Practice Address - Fax:804-520-2280
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist