Provider Demographics
NPI:1275977761
Name:LIPPS, KRISTI G (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:G
Last Name:LIPPS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11176 CAMPFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34614-3162
Mailing Address - Country:US
Mailing Address - Phone:352-812-9881
Mailing Address - Fax:
Practice Address - Street 1:11176 CAMPFIELD RD
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34614-3162
Practice Address - Country:US
Practice Address - Phone:352-812-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9226232363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health