Healthcare Provider Details
I. General information
NPI: 1730550054
Provider Name (Legal Business Name): ADINA MARIE SIPPEL CNM, MS, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/13/2015
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1101 SPRING CREEK RD
EAST RIDGE TN
37412-3913
US
IV. Provider business mailing address
1101 SPRING CREEK RD
EAST RIDGE TN
37412-3913
US
V. Phone/Fax
- Phone: 423-553-5999
- Fax: 423-541-6579
- Phone: 423-553-5999
- Fax: 423-541-6579
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 38928 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | AP129319 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: