Provider Demographics
NPI:1972010452
Name:SIPPLE, ELIZABETH MCKENZIE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MCKENZIE
Last Name:SIPPLE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:59 TIPTON DR
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-1603
Mailing Address - Country:US
Mailing Address - Phone:770-800-3455
Mailing Address - Fax:770-284-8380
Practice Address - Street 1:73 PRESTIGE LN STE 102
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6370
Practice Address - Country:US
Practice Address - Phone:770-800-3455
Practice Address - Fax:770-284-8380
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA230875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003222014CMedicaid