Provider Demographics
NPI:1528493822
Name:CHAPPELL, SUSAN E (RN,MSN,FNP-BC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:RN,MSN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2841
Mailing Address - Country:US
Mailing Address - Phone:415-888-3662
Mailing Address - Fax:415-888-6272
Practice Address - Street 1:239 MILLER AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2841
Practice Address - Country:US
Practice Address - Phone:415-888-3662
Practice Address - Fax:415-888-6272
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA669372363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily