Provider Demographics
NPI:1780840025
Name:CHAPMAN, BRANDY NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:NICOLE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 POINSETT HWY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-4427
Mailing Address - Country:US
Mailing Address - Phone:864-232-2292
Mailing Address - Fax:864-232-2215
Practice Address - Street 1:500 POINSETT HWY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-4427
Practice Address - Country:US
Practice Address - Phone:864-232-2292
Practice Address - Fax:864-232-2215
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH3378Medicaid
SCAA34889177OtherMEDICARE PTAN