Provider Demographics
NPI:1376670042
Name:CIPOLLINA, CARMELA M (MD)
Entity Type:Individual
Prefix:
First Name:CARMELA
Middle Name:M
Last Name:CIPOLLINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:NIXON
Mailing Address - State:NV
Mailing Address - Zip Code:89424-0227
Mailing Address - Country:US
Mailing Address - Phone:775-574-1018
Mailing Address - Fax:775-574-1028
Practice Address - Street 1:171 CAMPBELL LN
Practice Address - Street 2:
Practice Address - City:YERINGTON
Practice Address - State:NV
Practice Address - Zip Code:89447-9768
Practice Address - Country:US
Practice Address - Phone:775-783-0222
Practice Address - Fax:775-463-3016
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037455E208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice