Provider Demographics
NPI:1316224405
Name:TIPPITT, SHAWN MARIE (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:MARIE
Last Name:TIPPITT
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-557-0300
Mailing Address - Fax:281-557-3301
Practice Address - Street 1:400 W MEDICAL CENTER BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4402
Practice Address - Country:US
Practice Address - Phone:281-557-0300
Practice Address - Fax:281-557-3301
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX678871363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health