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General NPI Number Information
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NPI Number | 1720440787
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Entity Type | Organization
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Legal Business Name | LISA LIPPINCOTT APMHNP-BC PLLC
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 03/28/2016
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Provider Practice Location Address
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Address Line | 210 E MAIN ST STE 2B
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City | TUPELO
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State | MS
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Zip | 38804-4017
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Country | US
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Telephone | 662-844-3728
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Fax | 662-844-3739
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Provider Business Mailing Address
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Address Line | 210 E MAIN ST STE 2B
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City | TUPELO
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State | MS
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Zip | 38804-4017
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Country | US
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Telephone | 662-844-3728
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Fax | 662-844-3739
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LISA T LIPPINCOTT
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Credential | APMHNP-BC
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Telephone | 662-844-3728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R679054
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License Number State | MS
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