Provider Demographics
NPI:1619755659
Name:SIPE, ROBBIE CHEYANNE (PRSS)
Entity Type:Individual
Prefix:
First Name:ROBBIE
Middle Name:CHEYANNE
Last Name:SIPE
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:HEPZIBAH
Mailing Address - State:WV
Mailing Address - Zip Code:26369
Mailing Address - Country:US
Mailing Address - Phone:304-642-7438
Mailing Address - Fax:
Practice Address - Street 1:6 HOSPITAL PLAZA
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301
Practice Address - Country:US
Practice Address - Phone:304-623-5661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22-948175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist