Provider Demographics
NPI:1497732226
Name:KIPP, HEIDI L (NP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:L
Last Name:KIPP
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Gender:F
Credentials:NP
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Mailing Address - Street 1:2365 S CLINTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2645
Mailing Address - Country:US
Mailing Address - Phone:585-442-5320
Mailing Address - Fax:585-442-5526
Practice Address - Street 1:2365 S CLINTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2645
Practice Address - Country:US
Practice Address - Phone:585-442-5320
Practice Address - Fax:585-442-5526
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2023-07-05
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Provider Licenses
StateLicense IDTaxonomies
NY430141363LA2100X
NYF430141363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care