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General NPI Number Information
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NPI Number | 1447643341
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Entity Type | Individual
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Provider Name | COREY L. LIPE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 1250 E TREMONT ST
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City | HILLSBORO
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State | IL
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Zip | 62049-1912
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Country | US
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Telephone | 217-532-6911
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 S 6TH ST
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City | SPRINGFIELD
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State | IL
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Zip | 62703-2403
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Country | US
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Telephone | 217-528-7541
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209012634
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License Number State | IL
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