Healthcare Provider Details

I. General information

NPI: 1922987114
Provider Name (Legal Business Name): JASMINE RENEE CHAPMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2025
Last Update Date: 09/01/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

195 COGHILL DR
WINSTON SALEM NC
27103-9506
US

V. Phone/Fax

Practice location:
  • Phone: 336-407-6376
  • Fax:
Mailing address:
  • Phone: 336-407-6376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number332616
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: