Provider Demographics
NPI:1730807207
Name:CAPOLUPO, JOSEPH (DNP, CRNA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:CAPOLUPO
Suffix:
Gender:M
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 MYRTLE LN
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-5020
Mailing Address - Country:US
Mailing Address - Phone:818-632-7700
Mailing Address - Fax:
Practice Address - Street 1:1508 MYRTLE LN
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-5020
Practice Address - Country:US
Practice Address - Phone:818-632-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95106383163W00000X
NY958121367500000X
GARN315848367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse