Provider Demographics
NPI:1629700075
Name:CHAPMAN, CAROLINE CROSS
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CROSS
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1168 CLEARFIELD RD SW APT B
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-3847
Mailing Address - Country:US
Mailing Address - Phone:804-397-9470
Mailing Address - Fax:
Practice Address - Street 1:1168 CLEARFIELD RD SW APT B
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24015-3847
Practice Address - Country:US
Practice Address - Phone:804-397-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant