Provider Demographics
NPI:1891314928
Name:LIPSEY, TESSA (MD)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:LIPSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:
Other - Last Name:KLUMPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12401 E 17TH AVE FL 7
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2548
Mailing Address - Country:US
Mailing Address - Phone:720-429-2164
Mailing Address - Fax:
Practice Address - Street 1:13001 EAST 17TH PLACE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2581
Practice Address - Country:US
Practice Address - Phone:303-724-1784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0008133390200000X
VA0101282273207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program