Provider Demographics
NPI:1043773781
Name:CHAPPELL, DANIELLE FELICIA
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:FELICIA
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4184 BRIGHT CRK
Mailing Address - Street 2:
Mailing Address - City:HAHIRA
Mailing Address - State:GA
Mailing Address - Zip Code:31632-3199
Mailing Address - Country:US
Mailing Address - Phone:229-460-2048
Mailing Address - Fax:
Practice Address - Street 1:4184 BRIGHT CRK
Practice Address - Street 2:
Practice Address - City:HAHIRA
Practice Address - State:GA
Practice Address - Zip Code:31632-3199
Practice Address - Country:US
Practice Address - Phone:229-460-2048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA83-3934544Medicaid