Healthcare Provider Details

I. General information

NPI: 1013408657
Provider Name (Legal Business Name): COURTNEY CHAPPEL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 182
ORLANDO FL
32804-4675
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5600
  • Fax: 317-705-5047
Mailing address:
  • Phone: 407-303-2030
  • Fax: 407-303-2042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9321594
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN9321594
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: