MEDICARE: JANET MORRIS CRIPANUK ARNP

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	363L00000X	Nurse Practitioner	1399372	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	500023002	OTHER	FL	RR MEDICARE
3	P00019240	OTHER	FL	RR MEDICARE
4	P00019243	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	Y0259	OTHER	FL	BLUE SHIELD

General Provider Information

NPI Number	:	1861407579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET MORRIS CRIPANUK ARNP

Provider Business Mailing Address
First Line	:	8734 INDIAN RIVER RUN
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-2455
Country	:	US
Telephone Number	:	561-736-1538
Fax Number	:

Provider Business Practice Location Address
First Line	:	4847 DAVID S MACK DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-8023
Country	:	US
Telephone Number	:	567-946-7494
Fax Number	:

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

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	12/01/2022

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