Provider Demographics
NPI:1225198039
Name:CHAPPELL, JAMIE LEIGH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LEIGH
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2913
Mailing Address - Country:US
Mailing Address - Phone:256-401-4000
Mailing Address - Fax:
Practice Address - Street 1:9518 US HWY 231
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:AL
Practice Address - Zip Code:35136-0276
Practice Address - Country:US
Practice Address - Phone:256-377-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-089281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL891008570Medicaid
ALAL1-089281OtherSTATE LICENSE NUMBER
ALQ35096Medicare UPIN
ALAL1-089281OtherSTATE LICENSE NUMBER