Provider Demographics
NPI:1467223693
Name:CHAPPELL, EMILY GRACE (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:GRACE
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5561 N STURGEON RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-8382
Mailing Address - Country:US
Mailing Address - Phone:385-227-5958
Mailing Address - Fax:
Practice Address - Street 1:5561 N STURGEON RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-8382
Practice Address - Country:US
Practice Address - Phone:385-227-5958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704358437363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health