Provider Demographics
NPI:1427641331
Name:TIPTON, JESSICA C
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:C
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 1:22031 HADDEN RD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2145
Mailing Address - Country:US
Mailing Address - Phone:216-797-0463
Mailing Address - Fax:
Practice Address - Street 1:22031 HADDEN RD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2145
Practice Address - Country:US
Practice Address - Phone:216-797-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide