Provider Demographics
NPI:1639363203
Name:KIPROP, MICHELLE JOY (RN, NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JOY
Last Name:KIPROP
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:JOY
Other - Last Name:KERNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,NP
Mailing Address - Street 1:545 S SAN PEDRO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-2101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:545 S SAN PEDRO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2101
Practice Address - Country:US
Practice Address - Phone:213-673-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily