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General NPI Number Information
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NPI Number | 1285080028
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Entity Type | Individual
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Provider Name | ANN GIPPERT
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Gender | Female
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 1200 UNIVERSITY BLVD STE 101
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City | JUPITER
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State | FL
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Zip | 33458-5215
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Country | US
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Telephone | 561-249-2958
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Fax |
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Provider Business Mailing Address
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Address Line | 2574 SW WESTFIELD ST
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-2588
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Country | US
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Telephone | 561-543-6288
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 18436
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License Number State | FL
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