Provider Demographics
NPI:1346753472
Name:CHIPOLLINI, ANA URSULA (APRN FNP-BC PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:URSULA
Last Name:CHIPOLLINI
Suffix:
Gender:F
Credentials:APRN FNP-BC PMHNP-BC
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:URSULA
Other - Last Name:CHIPOLLINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN FNP-BC PMHNP-BC
Mailing Address - Street 1:2851 LEONARD DR APT J506
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3904
Mailing Address - Country:US
Mailing Address - Phone:479-856-2201
Mailing Address - Fax:
Practice Address - Street 1:2851 LEONARD DR APT J506
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-3904
Practice Address - Country:US
Practice Address - Phone:479-856-2203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-11
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9260761363LF0000X, 363LP0808X
FL9260761363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107910XXXMedicaid
FLAPRN9260761OtherPROFESSIONAL LICENSE
FL107910XXXMedicaid