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General NPI Number Information
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NPI Number | 1316677982
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Entity Type | Individual
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Provider Name | MICHAEL EDWIN TIPTON DNP AGNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 341 N FAYETTEVILLE ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5501
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Country | US
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Telephone | 833-510-4357
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Fax | 866-460-2997
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Provider Business Mailing Address
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Address Line | 4600 MONTGOMERY RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45212-2600
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Country | US
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Telephone | 833-510-4357
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Fax | 866-460-2997
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 5016373
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License Number State | NC
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