MEDICARE: MS. ADINA MARIE SIPPEL CNM, MS, RN

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	367A00000X	Advanced Practice Midwife	38928	TN
2	367A00000X	Advanced Practice Midwife	AP129319	TX

General Provider Information

NPI Number	:	1730550054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADINA MARIE SIPPEL CNM, MS, RN

Provider Business Mailing Address
First Line	:	1101 SPRING CREEK RD
Second Line	:
City	:	EAST RIDGE
State	:	TN
Zip	:	37412-3913
Country	:	US
Telephone Number	:	423-553-5999
Fax Number	:	423-541-6579

Provider Business Practice Location Address
First Line	:	1101 SPRING CREEK RD
Second Line	:
City	:	EAST RIDGE
State	:	TN
Zip	:	37412-3913
Country	:	US
Telephone Number	:	423-553-5999
Fax Number	:	423-541-6579

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

Provider Enumeration Date	:	10/13/2015
Last Update Date	:	09/29/2025

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