Provider Demographics
NPI:1912998873
Name:CHAPMAN, MELISSA A (PAC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:FRESCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:1406 6TH AVENUE NORTH
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1901
Mailing Address - Country:US
Mailing Address - Phone:320-251-2700
Mailing Address - Fax:320-255-5806
Practice Address - Street 1:1406 6TH AVENUE NORTH
Practice Address - Street 2:ST CLOUD HOSPITAL
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1901
Practice Address - Country:US
Practice Address - Phone:320-251-2700
Practice Address - Fax:320-255-5806
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9993363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
2374574OtherARAZ GROUP AMERICAS PPO
HP54852OtherHEALTH PARTNERS
0121331OtherMEDICA HEALTH PLANS
1044393OtherPREFERRED ONE
123922OtherUCARE
13R93FROtherBLUE CROSS BLUE SHIELD
2374574OtherARAZ GROUP AMERICAS PPO