Provider Demographics
NPI:1598593899
Name:KIPP, LEAH LORAINE (ARNP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:LORAINE
Last Name:KIPP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 ROLLING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-1252
Mailing Address - Country:US
Mailing Address - Phone:515-851-2859
Mailing Address - Fax:
Practice Address - Street 1:7300 WESTOWN PKWY STE 320
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-2527
Practice Address - Country:US
Practice Address - Phone:515-225-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA179657363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner