Provider Demographics
NPI:1841057825
Name:TIPTON, CAROL JEAN (RN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:JEAN
Last Name:TIPTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1157
Mailing Address - Country:US
Mailing Address - Phone:740-699-2300
Mailing Address - Fax:740-699-2310
Practice Address - Street 1:187 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1157
Practice Address - Country:US
Practice Address - Phone:740-699-2300
Practice Address - Fax:740-699-2310
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN415056163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice