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General NPI Number Information
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NPI Number | 1689237554
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Entity Type | Individual
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Provider Name | NICHOLAS ALLEN PIPPIN MS, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 1211 FISH HATCHERY RD
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City | MADISON
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State | WI
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Zip | 53715-1909
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Country | US
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Telephone | 815-509-9211
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 FISH HATCHERY RD
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City | MADISON
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State | WI
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Zip | 53715-1909
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Country | US
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Telephone | 815-509-9211
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3001
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096004285
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License Number State | IL
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