MEDICARE: NATALIA D CHAPMAN PA

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	363A00000X	Physician Assistant	4840	WI

General Provider Information

NPI Number	:	1902455900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA D CHAPMAN PA

Provider Business Mailing Address
First Line	:	2802 CISSERVILLE RD
Second Line	:
City	:	SOUTH WAYNE
State	:	WI
Zip	:	53587-9744
Country	:	US
Telephone Number	:	920-763-2497
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 22ND AVE
Second Line	:
City	:	MONROE
State	:	WI
Zip	:	53566
Country	:	US
Telephone Number	:	608-324-2000
Fax Number	:

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

Provider Enumeration Date	:	09/11/2019
Last Update Date	:	12/17/2020

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