Provider Demographics
NPI:1558378232
Name:CYPRIAN, ROGER AMBROUS (RN, CRNFA)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:AMBROUS
Last Name:CYPRIAN
Suffix:
Gender:M
Credentials:RN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SAINT ANDREWS LN
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-6905
Mailing Address - Country:US
Mailing Address - Phone:817-294-8182
Mailing Address - Fax:817-294-2412
Practice Address - Street 1:135 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-6905
Practice Address - Country:US
Practice Address - Phone:817-294-8182
Practice Address - Fax:817-294-2412
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX533044163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse