Provider Demographics
NPI:1396285995
Name:LIPE, AMY NICOLE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:NICOLE
Last Name:LIPE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-6216
Mailing Address - Country:US
Mailing Address - Phone:423-258-8277
Mailing Address - Fax:
Practice Address - Street 1:600 SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857-6216
Practice Address - Country:US
Practice Address - Phone:423-258-8277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily