Provider Demographics
NPI:1215383302
Name:KIPPEN, ABBY LEIGH (DC)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:LEIGH
Last Name:KIPPEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ABBY
Other - Middle Name:LEIGH
Other - Last Name:STAUSS KIPPEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2300 S ORCHARD ST STE A
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-6722
Mailing Address - Country:US
Mailing Address - Phone:208-383-3703
Mailing Address - Fax:208-383-3702
Practice Address - Street 1:2300 S ORCHARD ST STE A
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-6722
Practice Address - Country:US
Practice Address - Phone:208-383-3703
Practice Address - Fax:208-383-3702
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5739111N00000X
IDCHIA1694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor