Provider Demographics
NPI:1528512126
Name:KOLIPINSKI, MARYSIA CHIMES (FNP)
Entity type:Individual
Prefix:MISS
First Name:MARYSIA
Middle Name:CHIMES
Last Name:KOLIPINSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 TELEGRAPH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1710
Mailing Address - Country:US
Mailing Address - Phone:510-204-3986
Mailing Address - Fax:510-204-3948
Practice Address - Street 1:5700 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1710
Practice Address - Country:US
Practice Address - Phone:510-204-3986
Practice Address - Fax:510-204-3948
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004006363LF0000X
CA95032762163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse