MEDICARE: CRISTINA FELIPE FNP

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	363LF0000X	Family Nurse Practitioner	1033170	TX

General Provider Information

NPI Number	:	1578145314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA FELIPE FNP

Provider Business Mailing Address
First Line	:	122 W JOHN CARPENTER FWY STE 420
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-2014
Country	:	US
Telephone Number	:	972-957-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9622 WEBB CHAPEL RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75220-4940
Country	:	US
Telephone Number	:	214-358-3601
Fax Number	:	214-358-3639

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

Provider Enumeration Date	:	04/21/2021
Last Update Date	:	02/01/2022

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