MEDICARE: MRS. KRISTA LIPPOLD CRNP

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	363LF0000X	Family Nurse Practitioner	1-066260	AL
2	363LF0000X	Family Nurse Practitioner	R881358	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841337417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTA LIPPOLD CRNP

Provider Business Mailing Address
First Line	:	PO BOX 746063
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6063
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:

Provider Business Practice Location Address
First Line	:	3065 DAUPHIN ST
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36606-4040
Country	:	US
Telephone Number	:	251-271-7017
Fax Number	:	251-220-5536

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	08/26/2025

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