Provider Demographics
NPI:1871611178
Name:CHAPMAN, JESSICA ANN (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ANN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 SUMMERLIN RD # C-2272
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3005
Mailing Address - Country:US
Mailing Address - Phone:239-266-5362
Mailing Address - Fax:239-360-5371
Practice Address - Street 1:4600 SUMMERLIN RD # C-2272
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3005
Practice Address - Country:US
Practice Address - Phone:239-266-5362
Practice Address - Fax:239-360-5371
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13352225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110711800Medicaid