Provider Demographics
NPI:1023100120
Name:CHAPMAN, CATHY S (CRNP)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:S
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 NATIONAL HWY
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7325
Mailing Address - Country:US
Mailing Address - Phone:240-362-7294
Mailing Address - Fax:240-362-7366
Practice Address - Street 1:922 NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:240-362-7294
Practice Address - Fax:240-362-7366
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR069415363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD329444700Medicaid
WV9600036000Medicaid
WV9600036000Medicaid
MD235622YL4GOtherMEDICARE INDIVIDUAL PTAN
MC0206513OtherDEA REGISTRATION
MDS24767Medicare UPIN