Provider Demographics
NPI:1609810993
Name:LIPMAN, TERRI H (PHD, CRNP)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:H
Last Name:LIPMAN
Suffix:
Gender:F
Credentials:PHD, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 ROCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:MERION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1363
Mailing Address - Country:US
Mailing Address - Phone:610-667-6411
Mailing Address - Fax:215-590-3053
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-590-3174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP002271N363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics