Healthcare Provider Details

I. General information

NPI: 1427409523
Provider Name (Legal Business Name): DAVID GREGORY CUPIT JR. FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 MISSION ST
SAN FRANCISCO CA
94103-2543
US

IV. Provider business mailing address

19700 HICKORY TWIG WAY APT 41
SPRING TX
77388-6249
US

V. Phone/Fax

Practice location:
  • Phone: 415-746-1940
  • Fax: 415-746-1941
Mailing address:
  • Phone: 832-946-5213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61558063
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP131588
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95029923
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number801089
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: