Provider Demographics
NPI:1750574489
Name:CHAPMAN, JENNIFER FERLAND (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:FERLAND
Last Name:CHAPMAN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:FERLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5960 FAIRVIEW RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3113
Mailing Address - Country:US
Mailing Address - Phone:704-918-1934
Mailing Address - Fax:
Practice Address - Street 1:330 BILLINGSLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3096
Practice Address - Country:US
Practice Address - Phone:704-405-3953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01010363A00000X
NC001001010363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0397730004OtherNSC#
41750OtherBCBS
NC8941750Medicaid
41750OtherBCBS
NC8941750Medicaid