Provider Demographics
NPI:1871556019
Name:CHAPPELL, ALEXIS PULPHUS (LPN)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:PULPHUS
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 1:16223 SANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-3141
Mailing Address - Country:US
Mailing Address - Phone:216-738-0666
Mailing Address - Fax:216-692-1690
Practice Address - Street 1:16223 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-3141
Practice Address - Country:US
Practice Address - Phone:216-738-0666
Practice Address - Fax:216-692-1690
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN099262164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2380249Medicaid