Provider Demographics
NPI:1992934202
Name:CHAPP, STEPHANIE N (PA-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:N
Last Name:CHAPP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6940 VAN DORN ST.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506
Mailing Address - Country:US
Mailing Address - Phone:402-323-8572
Mailing Address - Fax:402-323-8579
Practice Address - Street 1:6940 VAN DORN ST.
Practice Address - Street 2:SUITE 201
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506
Practice Address - Country:US
Practice Address - Phone:402-323-8572
Practice Address - Fax:402-323-8579
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1452363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant