Healthcare Provider Details

I. General information

NPI: 1669530184
Provider Name (Legal Business Name): ANGELA HIPSKIND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 11/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 E CREEKS EDGE DR
BLOOMINGTON IN
47401-8368
US

IV. Provider business mailing address

2605 E CREEKS EDGE DR
BLOOMINGTON IN
47401-8368
US

V. Phone/Fax

Practice location:
  • Phone: 812-333-1933
  • Fax: 812-333-3991
Mailing address:
  • Phone: 812-333-1933
  • Fax: 812-333-3991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71001865A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: