Provider Demographics
NPI:1033214473
Name:ZIPPRICH, ANDREA KAREN (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:KAREN
Last Name:ZIPPRICH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16225 160TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:THIEF RIVER FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56701
Mailing Address - Country:US
Mailing Address - Phone:320-252-5777
Mailing Address - Fax:320-258-3136
Practice Address - Street 1:211 N LABREE AVENUE
Practice Address - Street 2:MIDWEST VISION CENTERS
Practice Address - City:THIEF RIVER FALLS
Practice Address - State:MN
Practice Address - Zip Code:56701
Practice Address - Country:US
Practice Address - Phone:218-681-5606
Practice Address - Fax:218-681-5609
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2340152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2202059OtherMEDICA
MN284R2ZIOtherBCBS
MN284R2ZIOtherBCBS