Provider Demographics
NPI:1861407579
Name:CRIPANUK, JANET MORRIS (ARNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:MORRIS
Last Name:CRIPANUK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8734 INDIAN RIVER RUN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-2455
Mailing Address - Country:US
Mailing Address - Phone:561-736-1538
Mailing Address - Fax:
Practice Address - Street 1:4847 DAVID S MACK DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-8023
Practice Address - Country:US
Practice Address - Phone:567-946-7494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1399372363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305536100Medicaid
FL500023002OtherRR MEDICARE
FLP00019240OtherRR MEDICARE
FLP00019243OtherRR MEDICARE
FL75191038Medicaid
FLY0259OtherBLUE SHIELD
P32674Medicare UPIN
FLY0259OtherBLUE SHIELD
FLP00019243OtherRR MEDICARE
FL305536100Medicaid