Provider Demographics
NPI:1568176022
Name:TIPPETT, COURTNEY (OTA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:TIPPETT
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:HURST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2810 W US HIGHWAY 64 STE 2
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-4061
Mailing Address - Country:US
Mailing Address - Phone:828-516-1700
Mailing Address - Fax:828-516-1693
Practice Address - Street 1:240 CUNNINGHAM RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7576
Practice Address - Country:US
Practice Address - Phone:828-634-7800
Practice Address - Fax:828-634-7732
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15303224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC15303OtherOTA LICENSE