Provider Demographics
NPI:1922260124
Name:LIPPERT, JOANNE LEE (LPN)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:LEE
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W WATER ST
Mailing Address - Street 2:4A
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-2587
Mailing Address - Country:US
Mailing Address - Phone:419-502-6249
Mailing Address - Fax:
Practice Address - Street 1:105 W WATER ST
Practice Address - Street 2:4A
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-2587
Practice Address - Country:US
Practice Address - Phone:419-502-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN030856164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse