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NPI Code Detail

MEDICARE: DR. ANDREA LYN TIPPLE MD

MEDICARE: DR. ANDREA LYN TIPPLE MD
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
1207V00000XObstetrics & Gynecology Physician28999MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811973886
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA LYN TIPPLE MD
Provider Business Mailing Address
First Line : 1500 CURVE CREST BLVD W
Second Line :
City : STILLWATER
State : MN
Zip : 55082-6040
Country : US
Telephone Number : 651-439-1234
Fax Number : 651-439-1547
Provider Business Practice Location Address
First Line : 921 GREELEY ST S
Second Line :
City : STILLWATER
State : MN
Zip : 55082-5935
Country : US
Telephone Number : 651-439-1234
Fax Number : 651-439-1547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 08/13/2018

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Directions to “ DR. ANDREA LYN TIPPLE MD” Practice Location

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