Basic Information
Provider Information
NPI: 1023391158
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: JESSICA
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NEWTON
OtherFirstName: JESSICA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 5300 N INDEPENDENCE AVE
Address2: SUITE 280
City: OKLAHOMA CITY
State: OK
PostalCode: 731125556
CountryCode: US
TelephoneNumber: 4059493393
FaxNumber: 4059455493
Practice Location
Address1: 3300 NW EXPRESSWAY
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731124418
CountryCode: US
TelephoneNumber: 4059493393
FaxNumber: 4059496977
Other Information
ProviderEnumerationDate: 09/26/2011
LastUpdateDate: 02/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X93172OKY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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