Provider Demographics
NPI:1851446397
Name:CHAPMAN, STACEY ALLEN (ANP-BC)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:ALLEN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:3720 DAVINCI CT STE 400
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-7625
Mailing Address - Country:US
Mailing Address - Phone:404-290-7441
Mailing Address - Fax:
Practice Address - Street 1:3720 DAVINCI CT
Practice Address - Street 2:SUITE 400
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-7627
Practice Address - Country:US
Practice Address - Phone:770-300-3502
Practice Address - Fax:770-582-4189
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN116858363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health