Provider Demographics
NPI:1568238236
Name:HIPP, JAIMEE LEAVIRN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JAIMEE
Middle Name:LEAVIRN
Last Name:HIPP
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ALONZO CT
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-1257
Mailing Address - Country:US
Mailing Address - Phone:928-388-9624
Mailing Address - Fax:
Practice Address - Street 1:1049 JOHN SIMS PKWY E STE 2
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-2760
Practice Address - Country:US
Practice Address - Phone:850-842-3128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029963363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care