Provider Demographics
NPI:1285829762
Name:NIPP, JESSICA ANNE (CPM, RM, LMT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANNE
Last Name:NIPP
Suffix:
Gender:F
Credentials:CPM, RM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7175 DELMONICO DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1223
Mailing Address - Country:US
Mailing Address - Phone:719-661-9028
Mailing Address - Fax:
Practice Address - Street 1:7175 DELMONICO DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1223
Practice Address - Country:US
Practice Address - Phone:719-661-9028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-08
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO96176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife