MEDICARE: TRAVIS CHAPMAN NP

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	363L00000X	Nurse Practitioner	17348	TN
2	363LF0000X	Family Nurse Practitioner	9435037	FL
3	363LF0000X	Family Nurse Practitioner	AC001862	MD

General Provider Information

NPI Number	:	1912247263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS CHAPMAN NP

Provider Business Mailing Address
First Line	:	4450 N STATE ROAD 7
Second Line	:	STE 1
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33073-3354
Country	:	US
Telephone Number	:	423-408-7220
Fax Number	:	423-405-7405

Provider Business Practice Location Address
First Line	:	4450 N STATE ROAD 7
Second Line	:	STE 1
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33073-3354
Country	:	US
Telephone Number	:	423-408-7220
Fax Number	:	423-405-7405

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

Provider Enumeration Date	:	02/25/2013
Last Update Date	:	05/10/2017

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