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General NPI Number Information
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NPI Number | 1750101069
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Entity Type | Individual
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Provider Name | MICHELLE LIPP RN
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Gender | Female
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 722 NW 7TH ST
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City | BRAINERD
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State | MN
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Zip | 56401-2912
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Country | US
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Telephone | 218-825-2609
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Fax |
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Provider Business Mailing Address
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Address Line | 25011 HUDSON ST
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City | NISSWA
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State | MN
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Zip | 56468-4504
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Country | US
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Telephone | 218-821-3713
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 2521459
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License Number State | MN
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