Provider Demographics
NPI:1205637881
Name:LIPSCOMB, JUDY
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:LIPSCOMB
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 RED LANE RD
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-5939
Mailing Address - Country:US
Mailing Address - Phone:804-381-1593
Mailing Address - Fax:
Practice Address - Street 1:2363 RED LANE RD
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5939
Practice Address - Country:US
Practice Address - Phone:804-381-1593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider