Provider Demographics
NPI:1780113613
Name:CHAPPELL, KYLE (LPN)
Entity type:Individual
Prefix:MS
First Name:KYLE
Middle Name:
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 GOODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-2933
Mailing Address - Country:US
Mailing Address - Phone:929-378-1938
Mailing Address - Fax:
Practice Address - Street 1:26 GOODWIN AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-2933
Practice Address - Country:US
Practice Address - Phone:929-378-1938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3274441164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse