Provider Demographics
NPI:1912247263
Name:CHAPMAN, TRAVIS (NP)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 N STATE ROAD 7
Mailing Address - Street 2:STE 1
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3354
Mailing Address - Country:US
Mailing Address - Phone:423-408-7220
Mailing Address - Fax:423-405-7405
Practice Address - Street 1:4450 N STATE ROAD 7
Practice Address - Street 2:STE 1
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33073-3354
Practice Address - Country:US
Practice Address - Phone:423-408-7220
Practice Address - Fax:423-405-7405
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17348363L00000X
FL9435037363LF0000X
MDAC001862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I502430Medicare PIN