Provider Demographics
NPI:1952777138
Name:CHAPMAN, TANYA (APNP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16655 W BLUEMOUND RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5957
Mailing Address - Country:US
Mailing Address - Phone:414-257-1708
Mailing Address - Fax:
Practice Address - Street 1:16655 W BLUEMOUND RD
Practice Address - Street 2:SUITE 310
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5957
Practice Address - Country:US
Practice Address - Phone:414-257-1708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI160552163W00000X
WI6614-33363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse