Provider Demographics
NPI:1124085022
Name:CHAPPELLE, RAQUEL G (CRNA)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:G
Last Name:CHAPPELLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 CAROLINA CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4382
Mailing Address - Country:US
Mailing Address - Phone:334-279-1802
Mailing Address - Fax:334-293-8062
Practice Address - Street 1:7703 FLOYD CURL DRIVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3900
Practice Address - Country:US
Practice Address - Phone:210-567-4500
Practice Address - Fax:210-567-0083
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-069705367500000X
TX658822367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152974502Medicaid
AL009948685Medicaid
TX8L11014Medicare PIN
AL009948685Medicaid
TX152974502Medicaid
TX8J5733Medicare PIN