Provider Demographics
NPI:1801149646
Name:CHAPMAN, CHARLENE C (NP)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:C
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1219
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-7219
Mailing Address - Country:US
Mailing Address - Phone:512-715-3114
Mailing Address - Fax:512-715-3116
Practice Address - Street 1:200 COUNTY ROAD 340A BLDG II
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-4537
Practice Address - Country:US
Practice Address - Phone:512-715-3114
Practice Address - Fax:512-715-3116
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX722915363LA2100X
TXAP122668363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1801149646OtherNPI