Provider Demographics
NPI:1528629862
Name:CHAPMAN, MICHELLE MELISSA (APRN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MELISSA
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 MOTT-SMITH DR APT 2614
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-2845
Mailing Address - Country:US
Mailing Address - Phone:808-367-9620
Mailing Address - Fax:
Practice Address - Street 1:94-1211 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3205
Practice Address - Country:US
Practice Address - Phone:808-307-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2461363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics