Provider Demographics
NPI:1164505525
Name:PIPPIN, CHERYL LYNN (MSN, PNP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNN
Last Name:PIPPIN
Suffix:
Gender:F
Credentials:MSN, PNP
Other - Prefix:MISS
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:BREZIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1322 E MCANDREWS RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6177
Mailing Address - Country:US
Mailing Address - Phone:541-773-3688
Mailing Address - Fax:541-773-3125
Practice Address - Street 1:1322 E MCANDREWS RD STE 202
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6177
Practice Address - Country:US
Practice Address - Phone:541-773-3688
Practice Address - Fax:541-773-3125
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR099006263PNPN2363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics