Healthcare Provider Details

I. General information

NPI: 1124667654
Provider Name (Legal Business Name): CHAPPELL EVANS MS, ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2020
Last Update Date: 01/01/2020
Certification Date: 01/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 BEN WEINER DR
NEW ORLEANS LA
70118-3370
US

IV. Provider business mailing address

333 BEN WEINER DR
NEW ORLEANS LA
70118-3370
US

V. Phone/Fax

Practice location:
  • Phone: 504-862-8203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: