Provider Demographics
NPI:1457997975
Name:KIPP, TAMMI
Entity Type:Individual
Prefix:
First Name:TAMMI
Middle Name:
Last Name:KIPP
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 1:1326 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-9741
Mailing Address - Country:US
Mailing Address - Phone:567-217-1290
Mailing Address - Fax:
Practice Address - Street 1:1326 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-9741
Practice Address - Country:US
Practice Address - Phone:567-217-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant