Provider Demographics
NPI:1619162971
Name:CHAPPELL, KATRINA AUER (LMBT)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:AUER
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FAIRVIEW HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-9777
Mailing Address - Country:US
Mailing Address - Phone:828-713-1546
Mailing Address - Fax:
Practice Address - Street 1:2 FAIRVIEW HILLS DR
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-9777
Practice Address - Country:US
Practice Address - Phone:828-713-1546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5037225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist