Provider Demographics
NPI:1508180969
Name:LIPPINCOTT, TAMMY MARIE (CRNP (FAMILY))
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:MARIE
Last Name:LIPPINCOTT
Suffix:
Gender:F
Credentials:CRNP (FAMILY)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 STATION AVENUE
Mailing Address - Street 2:DESALES UNIVERSITY HEALTH CENTER
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-9568
Mailing Address - Country:US
Mailing Address - Phone:610-282-1100
Mailing Address - Fax:610-282-0943
Practice Address - Street 1:2755 STATION AVENUE
Practice Address - Street 2:DESALES UNIVERSITY HEALTH CENTER
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9568
Practice Address - Country:US
Practice Address - Phone:610-282-1100
Practice Address - Fax:610-282-0943
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily