Healthcare Provider Details

I. General information

NPI: 1184098089
Provider Name (Legal Business Name): MARTHA SIPE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2015
Last Update Date: 05/13/2022
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 COLLEGE AVE STE 201
LANCASTER PA
17603-3384
US

IV. Provider business mailing address

233 COLLEGE AVE STE 201
LANCASTER PA
17603-3384
US

V. Phone/Fax

Practice location:
  • Phone: 717-291-6752
  • Fax: 717-291-6751
Mailing address:
  • Phone: 717-291-6752
  • Fax: 717-291-6751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP018801
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP018801
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN252571
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: