Provider Demographics
NPI:1528751492
Name:CHAPLINE, JORDAN T
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:T
Last Name:CHAPLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6340 KENDALL RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9259
Mailing Address - Country:US
Mailing Address - Phone:443-986-5887
Mailing Address - Fax:
Practice Address - Street 1:6340 KENDALL RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9259
Practice Address - Country:US
Practice Address - Phone:443-986-5887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant