Healthcare Provider Details

I. General information

NPI: 1205566783
Provider Name (Legal Business Name): JENNIFER ELYSE CHAPMAN APRN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ELYSE JANOK

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 PARK EAST DR STE 450
BEACHWOOD OH
44122-4318
US

IV. Provider business mailing address

PO BOX 211699
EAGAN MN
55121-3699
US

V. Phone/Fax

Practice location:
  • Phone: 866-849-0692
  • Fax: 888-973-8821
Mailing address:
  • Phone: 866-849-0692
  • Fax: 888-973-8821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0031049
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: