Provider Demographics
NPI:1881191898
Name:LIPANOT, KRISTIN CATHERINE BROWN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:CATHERINE BROWN
Last Name:LIPANOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:CATHERINE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11700 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4656
Practice Address - Country:US
Practice Address - Phone:317-880-3900
Practice Address - Fax:317-880-0545
Is Sole Proprietor?:No
Enumeration Date:2018-04-07
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN01085694A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program