Provider Demographics
NPI:1811758626
Name:CHAPA, CATHRYN (CPNP-PC)
Entity type:Individual
Prefix:
First Name:CATHRYN
Middle Name:
Last Name:CHAPA
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3198 PRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-6975
Mailing Address - Country:US
Mailing Address - Phone:248-924-1043
Mailing Address - Fax:
Practice Address - Street 1:49650 CHERRY HILL RD STE 210
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4859
Practice Address - Country:US
Practice Address - Phone:734-398-7899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704341676363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics