Provider Demographics
NPI:1770733289
Name:CHAPOT, JENNIFER N (PA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:N
Last Name:CHAPOT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 AIRPORT EAST RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31216-7984
Mailing Address - Country:US
Mailing Address - Phone:478-785-6084
Mailing Address - Fax:414-622-3867
Practice Address - Street 1:3030 AIRPORT EAST RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31216-7984
Practice Address - Country:US
Practice Address - Phone:478-785-6084
Practice Address - Fax:414-622-3867
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08334363A00000X
VA0110007908363A00000X
GA12212363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant