Provider Demographics
NPI:1295471126
Name:TIPPETT, SHERRY ANN
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:TIPPETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10593 US HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:AL
Mailing Address - Zip Code:35136-5065
Mailing Address - Country:US
Mailing Address - Phone:334-324-1652
Mailing Address - Fax:
Practice Address - Street 1:10593 US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:AL
Practice Address - Zip Code:35136-5065
Practice Address - Country:US
Practice Address - Phone:334-324-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL--3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider