Provider Demographics
NPI:1891478889
Name:CHIPPI, GINA MARIA (MS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:MARIA
Last Name:CHIPPI
Suffix:
Gender:F
Credentials:MS, PA-C
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Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46961 VAN DYKE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317
Mailing Address - Country:US
Mailing Address - Phone:586-991-5205
Mailing Address - Fax:
Practice Address - Street 1:46961 VAN DYKE AVENUE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317
Practice Address - Country:US
Practice Address - Phone:586-991-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601011810363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant