Provider Demographics
NPI:1952367443
Name:CHAPPELL, KAY LYN (CRNA)
Entity type:Individual
Prefix:
First Name:KAY LYN
Middle Name:
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14975 OAK DEN LN
Mailing Address - Street 2:
Mailing Address - City:STE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-9041
Mailing Address - Country:US
Mailing Address - Phone:575-420-6764
Mailing Address - Fax:
Practice Address - Street 1:1400 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4100
Practice Address - Country:US
Practice Address - Phone:363-933-1000
Practice Address - Fax:319-356-2940
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD105565367500000X
MORN133574367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO915875413Medicaid
MOP00006296OtherRR MEDICARE
MOP00620229Medicare PIN
MO000060593Medicare PIN
MOP00006296OtherRR MEDICARE