Healthcare Provider Details

I. General information

NPI: 1992084222
Provider Name (Legal Business Name): JAMIE MARIE CHAPMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3408 MILLER RD STE 369
KALAMAZOO MI
49001-4111
US

IV. Provider business mailing address

3308 WADSWORTH LN
PORTAGE MI
49024-7400
US

V. Phone/Fax

Practice location:
  • Phone: 866-319-3595
  • Fax:
Mailing address:
  • Phone: 269-625-1899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704246600
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704246600
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28177932A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: