Provider Demographics
NPI:1265174288
Name:TIPTON, ELENI MAE
Entity type:Individual
Prefix:
First Name:ELENI
Middle Name:MAE
Last Name:TIPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1833
Mailing Address - Country:US
Mailing Address - Phone:740-297-8859
Mailing Address - Fax:740-297-4786
Practice Address - Street 1:2529 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1833
Practice Address - Country:US
Practice Address - Phone:740-297-8859
Practice Address - Fax:740-297-4786
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist