Provider Demographics
NPI:1609187459
Name:LIPSKY, KAITLIN E (NP)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:E
Last Name:LIPSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:E
Other - Last Name:LENAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481
Mailing Address - Country:US
Mailing Address - Phone:781-431-2345
Mailing Address - Fax:781-239-9966
Practice Address - Street 1:65 WALNUT ST
Practice Address - Street 2:SUITE 500
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:781-431-2345
Practice Address - Fax:781-239-9966
Is Sole Proprietor?:No
Enumeration Date:2010-06-27
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2259057363LF0000X
MARN2259057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily