Individual
VANESSA ALICIA CHAPMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6159 WHITE TIP RD, JACKSONVILLE, FL 32258-3115
(904) 572-2162
Mailing address
13720 OLD ST AUGUSTINE RD, JACKSONVILLE, FL 32258-7414
(904) 572-2162
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
1358731
FL
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
81-1759923
FL
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-1759923
—
FL
Enumeration date
01/28/2017
Last updated
01/10/2020
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