Provider Demographics
NPI:1588852412
Name:CIPPARONE, KELLY JEAN (RN)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:JEAN
Last Name:CIPPARONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 PARK BEND DR
Mailing Address - Street 2:BLDG 3, SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5387
Mailing Address - Country:US
Mailing Address - Phone:512-467-2727
Mailing Address - Fax:512-873-7576
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:BLDG 3, SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-467-2727
Practice Address - Fax:512-873-7576
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX656529364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health