Provider Demographics
NPI:1003622085
Name:CHAPPELL, JAHID SHABAZZ
Entity type:Individual
Prefix:
First Name:JAHID
Middle Name:SHABAZZ
Last Name:CHAPPELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 GAHL TER APT B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3649
Mailing Address - Country:US
Mailing Address - Phone:513-692-5222
Mailing Address - Fax:
Practice Address - Street 1:32 GAHL TER APT B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-3649
Practice Address - Country:US
Practice Address - Phone:513-692-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care