MEDICARE: CECILIA R CHAPMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	800312	AZ

General Provider Information

NPI Number	:	1356831036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA R CHAPMAN

Provider Business Mailing Address
First Line	:	1975 E SCORPIO PL
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85249-3691
Country	:	US
Telephone Number	:	480-213-2774
Fax Number	:	480-699-2069

Provider Business Practice Location Address
First Line	:	1410 W GUADALUPE RD STE 101
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-3039
Country	:	US
Telephone Number	:	480-497-5933
Fax Number	:	480-497-5934

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2018
Last Update Date	:	05/17/2018

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Directions to “ CECILIA R CHAPMAN ” Practice Location

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