Provider Demographics
NPI:1194935338
Name:CHAPPLE, JENNIFER JEAN
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JEAN
Last Name:CHAPPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 HILLMAN RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-2150
Mailing Address - Country:US
Mailing Address - Phone:330-784-6436
Mailing Address - Fax:
Practice Address - Street 1:401 HILLMAN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-2150
Practice Address - Country:US
Practice Address - Phone:330-784-6436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2120752Medicaid