Provider Demographics
NPI:1306892054
Name:DEKUIPER, CYNTHIA-MARIE CAPIRAL (CRNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA-MARIE
Middle Name:CAPIRAL
Last Name:DEKUIPER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ALTAIR PKWY STE 3100
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7653
Mailing Address - Country:US
Mailing Address - Phone:614-360-9995
Mailing Address - Fax:614-745-0165
Practice Address - Street 1:400 ALTAIR PKWY
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7652
Practice Address - Country:US
Practice Address - Phone:614-360-9995
Practice Address - Fax:614-745-0165
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY51188363LA2100X
OH0030918363LA2100X
IDNP488A363LF0000X
MI4704223514363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDNPNM7OtherBLUE CROSS OF ID
ID000010149360OtherREGENCE BLUE SHIELD OF ID
ID000010149360OtherREGENCE BLUE SHIELD OF ID
IDP33060Medicare UPIN