Provider Demographics
NPI:1285857672
Name:LIPSETT, LAURA B (ARNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:LIPSETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:B
Other - Last Name:KUHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1026 A AVENUE NE
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5036
Mailing Address - Country:US
Mailing Address - Phone:319-368-5976
Mailing Address - Fax:319-368-5932
Practice Address - Street 1:400 SOUTH BLAIRSFERRY CROSSING
Practice Address - Street 2:SUITE B
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233
Practice Address - Country:US
Practice Address - Phone:319-368-5950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF081672363L00000X
IAF-081672363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0761395Medicaid
IA0761395Medicaid