Provider Demographics
NPI:1649892407
Name:CHAPMAN, AMY MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BERLIN HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44814-9605
Mailing Address - Country:US
Mailing Address - Phone:440-714-3833
Mailing Address - Fax:
Practice Address - Street 1:62 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BERLIN HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44814-9605
Practice Address - Country:US
Practice Address - Phone:440-714-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.126740.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse