Healthcare Provider Details

I. General information

NPI: 1740829027
Provider Name (Legal Business Name): CRISTOPHER NICOLAS CIPRIANO NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 HARRY HINES BLVD
DALLAS TX
75390-5649
US

IV. Provider business mailing address

6201 HARRY HINES BLVD
DALLAS TX
75390-0001
US

V. Phone/Fax

Practice location:
  • Phone: 214-786-5386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP144488
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP144488
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: