Provider Demographics
NPI:1447731484
Name:CHAPMAN, SHAYDREA L (RMA)
Entity type:Individual
Prefix:
First Name:SHAYDREA
Middle Name:L
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 MARTIN DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-5764
Mailing Address - Country:US
Mailing Address - Phone:404-528-9017
Mailing Address - Fax:
Practice Address - Street 1:337 MARTIN DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-5764
Practice Address - Country:US
Practice Address - Phone:404-528-9017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric