MEDICARE: STEPHEN A LUIPPOLD RNCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	230124	MA
2	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	230124	MA

General Provider Information

NPI Number	:	1366460222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN A LUIPPOLD RNCS

Provider Business Mailing Address
First Line	:	17 KING ST
Second Line	:
City	:	HATFIELD
State	:	MA
Zip	:	01038-9774
Country	:	US
Telephone Number	:	617-733-7407
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 KING ST # S2676
Second Line	:
City	:	HATFIELD
State	:	MA
Zip	:	01038-9774
Country	:	US
Telephone Number	:	617-733-7407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	03/12/2024

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