Provider Demographics
NPI:1437885217
Name:PIPES, KEIRNEN DIANNE
Entity Type:Individual
Prefix:
First Name:KEIRNEN
Middle Name:DIANNE
Last Name:PIPES
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 1:803 DIVISION ST APT 1004
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5094
Mailing Address - Country:US
Mailing Address - Phone:850-276-7061
Mailing Address - Fax:
Practice Address - Street 1:803 DIVISION ST APT 1004
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5094
Practice Address - Country:US
Practice Address - Phone:850-276-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-182809106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician