Provider Demographics
NPI:1992273577
Name:SIPES, COURTNEY MARIE (APRN)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:SIPES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3137
Mailing Address - Country:US
Mailing Address - Phone:508-236-7040
Mailing Address - Fax:508-236-7043
Practice Address - Street 1:211 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3137
Practice Address - Country:US
Practice Address - Phone:508-222-5200
Practice Address - Fax:508-236-7043
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN267867363LF0000X
MARN2373045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily