Provider Demographics
NPI:1407129620
Name:LIPP, SHERRI MARJORIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:MARJORIE
Last Name:LIPP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:MARJORIE
Other - Last Name:ZEPNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:3806 S 52ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53220-2024
Mailing Address - Country:US
Mailing Address - Phone:414-378-5974
Mailing Address - Fax:
Practice Address - Street 1:3806 S 52ND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53220-2024
Practice Address - Country:US
Practice Address - Phone:414-378-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-18
Last Update Date:2012-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI306420-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse