Provider Demographics
NPI:1396873790
Name:CHAPPELL, KIMBERLY A (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:A
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:CALIF STATE UNIV STUDENT HEALTH SERVICES
Mailing Address - Street 2:400 WEST. 1ST STREET
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95929-0001
Mailing Address - Country:US
Mailing Address - Phone:530-898-5241
Mailing Address - Fax:530-898-4057
Practice Address - Street 1:CALIF STATE UNIV STUDENT HEALTH SERVICES
Practice Address - Street 2:400 WEST. 1ST STREET
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95929-0001
Practice Address - Country:US
Practice Address - Phone:530-898-5241
Practice Address - Fax:530-898-4057
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG85697207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine