Healthcare Provider Details

I. General information

NPI: 1306267141
Provider Name (Legal Business Name): SUSAN 'CHRISTY' CHRISTINE CHAPMAN RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTY CHAPMAN RN, BSN

II. Dates (important events)

Enumeration Date: 12/20/2013
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E MADRID AVE
LAS CRUCES NM
88001-2050
US

IV. Provider business mailing address

1600 E MADRID AVE
LAS CRUCES NM
88001-2050
US

V. Phone/Fax

Practice location:
  • Phone: 575-527-9546
  • Fax: 575-527-9553
Mailing address:
  • Phone: 575-527-9546
  • Fax: 575-527-9553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number321102
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: