Provider Demographics
NPI:1952946105
Name:CHAPPLE, BERNICE (LPN)
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:
Last Name:CHAPPLE
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 1:1600 AVONDALE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-1794
Mailing Address - Country:US
Mailing Address - Phone:870-733-9950
Mailing Address - Fax:
Practice Address - Street 1:1600 AVONDALE CIR
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-1794
Practice Address - Country:US
Practice Address - Phone:870-733-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL038440208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics