Provider Demographics
NPI:1689690968
Name:CIAPPONI, NELSA A (MD)
Entity Type:Individual
Prefix:
First Name:NELSA
Middle Name:A
Last Name:CIAPPONI
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 1:3111 SPRINGBANK LN
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3372
Mailing Address - Country:US
Mailing Address - Phone:704-540-3737
Mailing Address - Fax:704-540-5866
Practice Address - Street 1:3111 SPRINGBANK LN
Practice Address - Street 2:SUITE G
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3372
Practice Address - Country:US
Practice Address - Phone:704-540-3737
Practice Address - Fax:704-540-5866
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0095-00862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8922513Medicaid
NC22513OtherNCBCBS
2212687HMedicare ID - Type Unspecified
NC8922513Medicaid
NC2212687KMedicare PIN