Provider Demographics
NPI:1932927290
Name:CHAPPELL, MEGAN BROOKE
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:BROOKE
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:BROOKE
Other - Last Name:LOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1018 N KIRK WAY
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-2736
Mailing Address - Country:US
Mailing Address - Phone:405-830-3212
Mailing Address - Fax:
Practice Address - Street 1:1018 N KIRK WAY
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-2736
Practice Address - Country:US
Practice Address - Phone:405-830-3212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program