Provider Demographics
NPI:1336537026
Name:SIPE, STEPHANY (NP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANY
Middle Name:
Last Name:SIPE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 849
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46308-0849
Mailing Address - Country:US
Mailing Address - Phone:219-663-4888
Mailing Address - Fax:219-663-4877
Practice Address - Street 1:499 S COURT ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-4335
Practice Address - Country:US
Practice Address - Phone:219-663-4888
Practice Address - Fax:219-663-4877
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28123274A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner