Provider Demographics
NPI:1174238497
Name:LIPPINCOTT, GABRIELLE PEARL (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:PEARL
Last Name:LIPPINCOTT
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 STONYCREST CT
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-1900
Mailing Address - Country:US
Mailing Address - Phone:215-622-5055
Mailing Address - Fax:
Practice Address - Street 1:124 STONYCREST CT
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-1900
Practice Address - Country:US
Practice Address - Phone:215-622-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA007919133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered