Healthcare Provider Details

I. General information

NPI: 1750485181
Provider Name (Legal Business Name): MS. CHRISTINA TIPTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 W 2100 N
PLEASANT VIEW UT
84404-6500
US

IV. Provider business mailing address

2321 SIR BARTON WAY STE 140
LEXINGTON KY
40509-2437
US

V. Phone/Fax

Practice location:
  • Phone: 859-661-9660
  • Fax:
Mailing address:
  • Phone: 859-661-9660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number257351
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13617473-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: