Provider Demographics
NPI:1932664612
Name:CHIPMAN, WENDY BLAIR (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:BLAIR
Last Name:CHIPMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 CENTER ST STE 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1575
Mailing Address - Country:US
Mailing Address - Phone:706-494-4300
Mailing Address - Fax:706-660-2847
Practice Address - Street 1:1538 13TH AVE STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2544
Practice Address - Country:US
Practice Address - Phone:706-323-4000
Practice Address - Fax:706-323-4848
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN224459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily