Provider Demographics
NPI:1568429488
Name:CHAPMAN, PAMELA JEAN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JEAN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SHOREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR LAKE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77586-4611
Mailing Address - Country:US
Mailing Address - Phone:281-326-1171
Mailing Address - Fax:
Practice Address - Street 1:707 SHOREWOOD DR
Practice Address - Street 2:
Practice Address - City:TAYLOR LAKE VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:77586-4611
Practice Address - Country:US
Practice Address - Phone:281-326-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX036862367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088745706Medicaid
TX88423UOtherBCBS
TX8K3969Medicare UPIN