Provider Demographics
NPI:1285956433
Name:KIPPLE, JOHN CHRISTOPHER (APRN, MS, CRNA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:KIPPLE
Suffix:
Gender:M
Credentials:APRN, MS, CRNA
Other - Prefix:MR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:KIPPLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, MS, CRNA
Mailing Address - Street 1:1121 RIVER WOOD
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-0083
Mailing Address - Country:US
Mailing Address - Phone:239-595-5931
Mailing Address - Fax:307-448-4666
Practice Address - Street 1:1215 E COURT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5129
Practice Address - Country:US
Practice Address - Phone:830-379-5867
Practice Address - Fax:830-401-4035
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1002197367500000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG009TOtherBCBS