Provider Demographics
NPI:1306407903
Name:LIPSITZ, ABIGAIL (AGPCNP-C)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:LIPSITZ
Suffix:
Gender:F
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 CHESTERFIELD INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1201
Mailing Address - Country:US
Mailing Address - Phone:636-735-3577
Mailing Address - Fax:
Practice Address - Street 1:253 CHESTERFIELD INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1201
Practice Address - Country:US
Practice Address - Phone:636-735-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019007755363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology