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General NPI Number Information
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NPI Number | 1891295481
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Entity Type | Individual
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Provider Name | GREGORY THOMAS TIPTON DNP, APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 302 SUNSET DR STE 105
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2408
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Country | US
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Telephone | 423-282-1930
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Fax | 423-283-0608
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Provider Business Mailing Address
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Address Line | 302 SUNSET DR STE 103
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2408
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Country | US
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Telephone | 423-282-1930
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Fax | 423-283-0608
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23949
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 192570
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5016913
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License Number State | NC
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