MEDICARE: MS. KERRY CHAPLEY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP5221	AZ

General Provider Information

NPI Number	:	1700215191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KERRY CHAPLEY NP

Provider Business Mailing Address
First Line	:	914 N SAN FRANCISCO ST STE D
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-3254
Country	:	US
Telephone Number	:	928-985-1495
Fax Number	:

Provider Business Practice Location Address
First Line	:	914 N SAN FRANCISCO ST STE D
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-3254
Country	:	US
Telephone Number	:	928-985-1498
Fax Number	:	928-597-5198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	08/09/2021

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