Provider Demographics
NPI:1235395336
Name:LIPSKY, JESSICA COURTNEY (MSN, NP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:COURTNEY
Last Name:LIPSKY
Suffix:
Gender:F
Credentials:MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 WALNUT ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2118
Mailing Address - Country:US
Mailing Address - Phone:781-431-2345
Mailing Address - Fax:781-239-9966
Practice Address - Street 1:65 WALNUT ST
Practice Address - Street 2:SUITE 500
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2118
Practice Address - Country:US
Practice Address - Phone:781-431-2345
Practice Address - Fax:781-239-9966
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2011-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA274261363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA274261OtherNURSE PRACTIONER