Provider Demographics
NPI:1518267137
Name:CHAPPELL, KAITLIN T (NP)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:T
Last Name:CHAPPELL
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Gender:F
Credentials:NP
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Mailing Address - Street 1:5943 STADIUM DR
Mailing Address - Street 2:STE 1
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-3016
Mailing Address - Country:US
Mailing Address - Phone:269-552-2836
Mailing Address - Fax:269-552-2964
Practice Address - Street 1:2700 EAST CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002
Practice Address - Country:US
Practice Address - Phone:269-286-7050
Practice Address - Fax:269-286-7051
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
MI4704251624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily