Provider Demographics
NPI:1164893616
Name:PIPPENGER, RACHEL (NP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PIPPENGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 HEALTH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-1380
Mailing Address - Country:US
Mailing Address - Phone:574-647-2129
Mailing Address - Fax:574-335-0741
Practice Address - Street 1:2102 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NAPPANEE
Practice Address - State:IN
Practice Address - Zip Code:46550-9575
Practice Address - Country:US
Practice Address - Phone:574-862-2165
Practice Address - Fax:574-862-4112
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005813A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300076685Medicaid
IN000001419494OtherANTHEM
IN201326370Medicaid
IN000001419603OtherANTHEM
IN000001376711OtherANTHEM
IN000001417043OtherANTHEM
IN000000968749OtherANTHEM
IN000001419670OtherANTHEM