Provider Demographics
NPI:1659139269
Name:CHAPPELL, CRYSTAL (MSN, RN)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 S FALCON DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-5866
Mailing Address - Country:US
Mailing Address - Phone:513-373-8558
Mailing Address - Fax:
Practice Address - Street 1:1728 S FALCON DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-5866
Practice Address - Country:US
Practice Address - Phone:623-277-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN153336163WA2000X, 163WC1600X, 163WH0200X, 163WM0705X, 163WR0400X, 163WX0106X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN153336OtherARIZONA STATE BOARD OF NURSING