JACQUELINE DIANE TIPPETT


Address: 610 Sw 2nd Ave Apt 1, Dania Beach, FL 33004-3922
Phone: 9374750952

JACQUELINE DIANE TIPPETT (NPI# 1194344820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1194344820
Entity Type Individual
Full Name JACQUELINE DIANE TIPPETT
Credential APRN, AGACNP-BC
Practice Address 610 Sw 2nd Ave Apt 1
Dania Beach
FL 33004-3922
Practice Telephone 9374750952
Mailing Telephone 9374750952
Enumeration Date 2020-04-13
Last Update Date 2020-04-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
APRN11006764 FL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 610 SW 2ND AVE APT 1
City DANIA BEACH
State FL
Zip Code 33004-3922

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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

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Competitor

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City DANIA BEACH
Zip Code 33004

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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