Provider Demographics
NPI:1982161196
Name:CHAPPELL, ALLIE JONES (CPNP)
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:JONES
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:LYNNAE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:912 OGLETHORPE DR NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319
Mailing Address - Country:US
Mailing Address - Phone:678-768-5021
Mailing Address - Fax:
Practice Address - Street 1:1001 JOHNSON FERRY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:470-565-5131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-24
Last Update Date:2019-08-07
Deactivation Date:2019-07-12
Deactivation Code:
Reactivation Date:2019-08-07
Provider Licenses
StateLicense IDTaxonomies
GARN223515163WP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics