Provider Demographics
NPI:1902189335
Name:CHAPMAN, MICHELLE YVETTE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:YVETTE
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 1:366 SAM HOUSTON JONES PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70611-5602
Mailing Address - Country:US
Mailing Address - Phone:337-855-1341
Mailing Address - Fax:
Practice Address - Street 1:366 SAM HOUSTON JONES PKWY
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70611-5602
Practice Address - Country:US
Practice Address - Phone:337-855-1341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist