Provider Demographics
NPI:1659002954
Name:LIPPS, ALEXIS MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MICHELLE
Last Name:LIPPS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 HOSPITAL CENTER CMNS
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2837
Mailing Address - Country:US
Mailing Address - Phone:843-689-2895
Mailing Address - Fax:843-689-9270
Practice Address - Street 1:100 BUCKWALTER PLACE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5023
Practice Address - Country:US
Practice Address - Phone:843-836-7101
Practice Address - Fax:843-836-7112
Is Sole Proprietor?:No
Enumeration Date:2022-06-19
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC264704163WX0200X
SC26337363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0200XNursing Service ProvidersRegistered NurseOncology