Provider Demographics
NPI:1255630075
Name:CHAPMAN, JOLEEN (CST CFA)
Entity type:Individual
Prefix:
First Name:JOLEEN
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:CST CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 ANNIE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1214
Mailing Address - Country:US
Mailing Address - Phone:407-843-2811
Mailing Address - Fax:
Practice Address - Street 1:122 ANNIE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1214
Practice Address - Country:US
Practice Address - Phone:407-843-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2017-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical