1902246416 NPI number — KRISTIN CIPRIANO WASHINGTON ARNP, FNP-C

Table of content: KRISTIN CIPRIANO WASHINGTON ARNP, FNP-C (NPI 1902246416)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902246416 NPI number — KRISTIN CIPRIANO WASHINGTON ARNP, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WASHINGTON
Provider First Name:
KRISTIN
Provider Middle Name:
CIPRIANO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BLAND
Provider Other First Name:
KRISTIN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP, FNP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902246416
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4371 VERONICA S SHOEMAKER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33916-2216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-274-8200
Provider Business Mailing Address Fax Number:
239-278-3350

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 SE OCEAN BLVD STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STUART
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34994-2236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-287-4061
Provider Business Practice Location Address Fax Number:
844-647-8689
Provider Enumeration Date:
06/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APRN9301494 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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