Provider Demographics
NPI:1841903143
Name:CHAPMAN, NICOLET ALEXIS
Entity type:Individual
Prefix:
First Name:NICOLET
Middle Name:ALEXIS
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 SAW MILL DR
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-1635
Mailing Address - Country:US
Mailing Address - Phone:978-805-8620
Mailing Address - Fax:
Practice Address - Street 1:241 SAW MILL DR
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-1635
Practice Address - Country:US
Practice Address - Phone:978-805-8620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN6647133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered