Provider Demographics
NPI:1033969076
Name:TIPPING, BREANNE ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:BREANNE
Middle Name:ELIZABETH
Last Name:TIPPING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BREANNE
Other - Middle Name:ELIZABETH
Other - Last Name:WENK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 FLORENCE DR APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW STANTON
Mailing Address - State:PA
Mailing Address - Zip Code:15672-9765
Mailing Address - Country:US
Mailing Address - Phone:412-316-6541
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-6597
Practice Address - Fax:717-531-7790
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019569208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics