Provider Demographics
NPI:1972193639
Name:LIPPERT, MORGAN ELISE (DNP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELISE
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 N BALLAS RD STE 102B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2343
Mailing Address - Country:US
Mailing Address - Phone:314-996-7080
Mailing Address - Fax:
Practice Address - Street 1:3009 N BALLAS RD STE 102B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2343
Practice Address - Country:US
Practice Address - Phone:314-996-7080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022027522363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner