Provider Demographics
NPI:1821021767
Name:CHAPPELL, LEEANN DAWN
Entity Type:Individual
Prefix:MRS
First Name:LEEANN
Middle Name:DAWN
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54244 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:JERUSALEM
Mailing Address - State:OH
Mailing Address - Zip Code:43747-9621
Mailing Address - Country:US
Mailing Address - Phone:740-757-2855
Mailing Address - Fax:740-757-2855
Practice Address - Street 1:54244 BOSTON RD
Practice Address - Street 2:
Practice Address - City:JERUSALEM
Practice Address - State:OH
Practice Address - Zip Code:43747-9621
Practice Address - Country:US
Practice Address - Phone:740-757-2855
Practice Address - Fax:740-757-2855
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2441030Medicaid