Provider Demographics
NPI:1780093971
Name:CHAPPELL, BRENDA WASHINGTON (PHARMD)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:WASHINGTON
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10606 N MALL DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-4800
Mailing Address - Country:US
Mailing Address - Phone:225-291-4299
Mailing Address - Fax:225-291-0737
Practice Address - Street 1:10606 N MALL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-4800
Practice Address - Country:US
Practice Address - Phone:225-291-4299
Practice Address - Fax:225-291-0737
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA009931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist