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General NPI Number Information
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NPI Number | 1003899121
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Entity Type | Individual
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Provider Name | JOHNNY RAYMON CHAPPELL CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 129 N WASHINGTON ST
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City | SUMTER
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State | SC
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Zip | 29150-4949
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Country | US
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Telephone | 803-778-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 129 NORTH WASHINGTON STREET
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City | SUMTER
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State | SC
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Zip | 29150
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Country | US
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Telephone | 803-774-8726
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Fax | 803-774-9846
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 23193 RNA 259
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 41988
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License Number State | SC
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