Provider Demographics
NPI:1689981730
Name:LIPPERT, JANINE TERESA (ARNP)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:TERESA
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1055 WELLINGTON WAY
Mailing Address - Street 2:SUITE 275
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1259
Mailing Address - Country:US
Mailing Address - Phone:859-219-2828
Mailing Address - Fax:859-219-0524
Practice Address - Street 1:2801 PALUMBO DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1317
Practice Address - Country:US
Practice Address - Phone:859-278-8772
Practice Address - Fax:859-276-3565
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY6590P363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1086377OtherRN LICENSE NUMBER