Provider Demographics
NPI:1154473007
Name:PHIPPS, CHRISTINE FELICE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:FELICE
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11253 COUNTY ROAD 23
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN
Mailing Address - State:MN
Mailing Address - Zip Code:56339-3950
Mailing Address - Country:US
Mailing Address - Phone:320-986-2864
Mailing Address - Fax:
Practice Address - Street 1:11253 COUNTY ROAD 23
Practice Address - Street 2:
Practice Address - City:HOFFMAN
Practice Address - State:MN
Practice Address - Zip Code:56339-3950
Practice Address - Country:US
Practice Address - Phone:320-986-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100744225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN88G35OCOtherBCBSBP OF MN