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NPI Code Detail

MEDICARE: DR. CHARMEKA LIPSCOMB RN, FNP-C

MEDICARE: DR. CHARMEKA LIPSCOMB RN, FNP-C
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP122288TX
2363LF0000XFamily Nurse Practitioner672601TX

General Provider Information

NPI Number : 1962751305
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARMEKA LIPSCOMB RN, FNP-C
Provider Business Mailing Address
First Line : 4922 SPRING AVE
Second Line :
City : DALLAS
State : TX
Zip : 75210-1359
Country : US
Telephone Number : 214-421-7848
Fax Number :
Provider Business Practice Location Address
First Line : 4922 SPRING AVE
Second Line :
City : DALLAS
State : TX
Zip : 75210-1359
Country : US
Telephone Number : 214-421-7848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2012
Last Update Date : 02/26/2024

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