Provider Demographics
NPI:1043441991
Name:CHIPMAN, KATHLEEN B
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:B
Last Name:CHIPMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:B
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 FALLIN BLVD APT A7
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4366
Mailing Address - Country:US
Mailing Address - Phone:919-344-7075
Mailing Address - Fax:
Practice Address - Street 1:119 FALLIN BLVD APT A7
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4366
Practice Address - Country:US
Practice Address - Phone:919-344-7075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist