Provider Demographics
NPI:1598439911
Name:CIPRIANO, CHELSEA-VEA M (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHELSEA-VEA
Middle Name:M
Last Name:CIPRIANO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:V
Other - Last Name:CIPRIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5152 S 99TH CT APT 12
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-2181
Mailing Address - Country:US
Mailing Address - Phone:402-651-5958
Mailing Address - Fax:
Practice Address - Street 1:240 S 77TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4579
Practice Address - Country:US
Practice Address - Phone:866-716-7251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE17186OtherPHARMACIST LICENSE