Healthcare Provider Details

I. General information

NPI: 1689690968
Provider Name (Legal Business Name): NELSA A CIAPPONI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 SPRINGBANK LN SUITE G
CHARLOTTE NC
28226-3372
US

IV. Provider business mailing address

3111 SPRINGBANK LN SUITE G
CHARLOTTE NC
28226-3372
US

V. Phone/Fax

Practice location:
  • Phone: 704-540-3737
  • Fax: 704-540-5866
Mailing address:
  • Phone: 704-540-3737
  • Fax: 704-540-5866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0095-00862
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: