Healthcare Provider Details

I. General information

NPI: 1346385358
Provider Name (Legal Business Name): BEVERLYN LORETTA CHAPPLE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 PERLMAN DR
SPRING VALLEY NY
10977-5281
US

IV. Provider business mailing address

4 SKYLINE DR
HAWTHORNE NY
10532-2147
US

V. Phone/Fax

Practice location:
  • Phone: 845-426-7577
  • Fax: 845-426-6006
Mailing address:
  • Phone: 914-467-7314
  • Fax: 914-418-1044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number421141
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: