Provider Demographics
NPI:1699574426
Name:CHAPMAN, AMANDA LEE (RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:CHAPMAN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:CLYMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:490 N GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3079
Mailing Address - Country:US
Mailing Address - Phone:760-975-9939
Mailing Address - Fax:
Practice Address - Street 1:490 N GRAPE ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3079
Practice Address - Country:US
Practice Address - Phone:760-975-9939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95134693163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse