Provider Demographics
NPI:1437379112
Name:CHAPPELL, ERICA D (PT)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:D
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 NITTANY VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-9013
Mailing Address - Country:US
Mailing Address - Phone:570-726-0331
Mailing Address - Fax:570-726-0354
Practice Address - Street 1:7127 NITTANY VALLEY DR
Practice Address - Street 2:
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-9013
Practice Address - Country:US
Practice Address - Phone:570-726-0331
Practice Address - Fax:570-726-0354
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020180700001Medicaid
PA1020180700001Medicaid