Provider Demographics
NPI:1497513477
Name:LIPSCOMB, DONNA ANN
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ANN
Last Name:LIPSCOMB
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 1:14835 BANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-9201
Mailing Address - Country:US
Mailing Address - Phone:269-721-3395
Mailing Address - Fax:269-721-3397
Practice Address - Street 1:441 BEDFORD RD N
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-1424
Practice Address - Country:US
Practice Address - Phone:269-317-6826
Practice Address - Fax:269-721-3397
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home