1912161753 NPI number — MRS. KATHERINE KNEECE CHAPPELL APRN

Table of content: MRS. KATHERINE KNEECE CHAPPELL APRN (NPI 1912161753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912161753 NPI number — MRS. KATHERINE KNEECE CHAPPELL APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAPPELL
Provider First Name:
KATHERINE
Provider Middle Name:
KNEECE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KNEECE
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1912161753
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NINE MEDICAL PARK
Provider Second Line Business Mailing Address:
SUITE 200A
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-434-7950
Provider Business Mailing Address Fax Number:
803-434-8606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NINE MEDICAL PARK
Provider Second Line Business Practice Location Address:
SUITE 200A
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-434-7950
Provider Business Practice Location Address Fax Number:
803-434-8606
Provider Enumeration Date:
07/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  APRN3354 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NP1260 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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