Provider Demographics
NPI:1215774732
Name:CHIAPPONE, NICHOLAS ROBERT (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:ROBERT
Last Name:CHIAPPONE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 63RD ST N
Mailing Address - Street 2:
Mailing Address - City:KENNETH CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33709-5010
Mailing Address - Country:US
Mailing Address - Phone:727-520-4893
Mailing Address - Fax:
Practice Address - Street 1:4400 63RD ST N
Practice Address - Street 2:
Practice Address - City:KENNETH CITY
Practice Address - State:FL
Practice Address - Zip Code:33709-5010
Practice Address - Country:US
Practice Address - Phone:727-520-4893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11033813363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health