Provider Demographics
NPI:1992844492
Name:CHAPPELL, NICOLE LEIGH (WHNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LEIGH
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-4830
Mailing Address - Fax:704-316-4831
Practice Address - Street 1:14330 OAKHILL PARK LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3409
Practice Address - Country:US
Practice Address - Phone:704-316-4830
Practice Address - Fax:704-316-4831
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5002620363L00000X
NC0050-02620363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1992844492Medicaid
NC1992844492Medicaid
NCNC2713CMedicare UPIN