Healthcare Provider Details

I. General information

NPI: 1982420956
Provider Name (Legal Business Name): ABIGAIL RENEE TIPIS APRN/CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL RENEE BODLEY

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 AICHOLTZ RD STE 100
CINCINNATI OH
45245-1506
US

IV. Provider business mailing address

890 W LOVELAND AVE APT B4
LOVELAND OH
45140-2239
US

V. Phone/Fax

Practice location:
  • Phone: 513-751-6667
  • Fax: 513-587-0470
Mailing address:
  • Phone: 513-833-1458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0037928
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: