Provider Demographics
NPI:1194914705
Name:CHAPPELL, RACHEL N (PA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:N
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 HOUMA BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2970
Mailing Address - Country:US
Mailing Address - Phone:504-503-6781
Mailing Address - Fax:
Practice Address - Street 1:4200 HOUMA BLVD FL 2
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2970
Practice Address - Country:US
Practice Address - Phone:504-454-4102
Practice Address - Fax:504-454-4192
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200131363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02205772Medicaid
LA1020311Medicaid
LA57061P913Medicare PIN