MEDICARE: VICTORIA ANNETTE TIPPERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	APRN11036189	FL

General Provider Information

NPI Number	:	1467134080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA ANNETTE TIPPERY

Provider Business Mailing Address
First Line	:	3785 WESTMINSTER DR SE
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-5849
Country	:	US
Telephone Number	:	503-338-8953
Fax Number	:

Provider Business Practice Location Address
First Line	:	3785 WESTMINSTER DR SE
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-5849
Country	:	US
Telephone Number	:	503-338-8953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2023
Last Update Date	:	03/04/2026

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Directions to “ VICTORIA ANNETTE TIPPERY ” Practice Location

Language	Start Address	Practice Location

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