Provider Demographics
NPI:1922073600
Name:CHIPMAN, TERESE C (APRN BC)
Entity Type:Individual
Prefix:MS
First Name:TERESE
Middle Name:C
Last Name:CHIPMAN
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14 FORDHAM RD
Mailing Address - Street 2:THE BOSTON CENTER 2ND FLOOR
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-3006
Mailing Address - Country:US
Mailing Address - Phone:617-782-6460
Mailing Address - Fax:617-783-9685
Practice Address - Street 1:14 FORDHAM RD
Practice Address - Street 2:THE BOSTON CENTER 2ND FLOOR
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-3006
Practice Address - Country:US
Practice Address - Phone:617-782-6460
Practice Address - Fax:617-783-9685
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA122080364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent