Healthcare Provider Details

I. General information

NPI: 1144698770
Provider Name (Legal Business Name): MICHAEL CIPRIANI FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2015
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ROSALIND REDFERN GROVER PKWY
MIDLAND TX
79701-5846
US

IV. Provider business mailing address

2901 SAVOY PL
MIDLAND TX
79705-2315
US

V. Phone/Fax

Practice location:
  • Phone: 432-686-6600
  • Fax:
Mailing address:
  • Phone: 432-296-8028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP128999
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: