Provider Demographics
NPI:1760134837
Name:TIPTON, KAITLIN ROSEMARY (PMHNP)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:ROSEMARY
Last Name:TIPTON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4128 MCLEAN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3325
Mailing Address - Country:US
Mailing Address - Phone:513-288-3837
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE, ML 6015
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-0800
Practice Address - Fax:513-803-0823
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030057363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner