Provider Demographics
NPI:1952932204
Name:TIPTON, RACHEL LYNN
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
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 1:535 FORTUNE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3429
Mailing Address - Country:US
Mailing Address - Phone:402-933-2222
Mailing Address - Fax:402-505-3886
Practice Address - Street 1:535 FORTUNE DR STE 100
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3429
Practice Address - Country:US
Practice Address - Phone:402-933-2222
Practice Address - Fax:402-505-3886
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education