MEDICARE: MR. CRISTOPHER R LIPANA APRN

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	363LF0000X	Family Nurse Practitioner	839429	NV

General Provider Information

NPI Number	:	1457934887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CRISTOPHER R LIPANA APRN

Provider Business Mailing Address
First Line	:	10837 BEACH HOUSE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-5095
Country	:	US
Telephone Number	:	408-691-7120
Fax Number	:

Provider Business Practice Location Address
First Line	:	10837 BEACH HOUSE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-5095
Country	:	US
Telephone Number	:	408-691-7120
Fax Number	:

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

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	08/23/2023

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