Individual
MARY LOU CHAPPELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP CNM
Contact information
Practice address
143 NORTH ST, SUITE #4, AUBURN, NY 13021-1852
(315) 252-5028
(315) 252-1587
Mailing address
17 LANSING ST, AMMS, PC CREDENTIALING OFFICE, AUBURN, NY 13021-1983
(315) 255-7438
(315) 255-7099
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
307356-1
NY
363LW0102X
Women's Health Nurse Practitioner
F420219-1
NY
367A00000X
Advanced Practice Midwife
Primary
F000976
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03063027
—
NY
Enumeration date
11/20/2006
Last updated
07/19/2011
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