Individual
DR. EDWARD N TIPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LP
Contact information
Practice address
1291 BLUFF CREEK DR, CHASKA, MN 55318-9515
(952) 496-9757
Mailing address
1291 BLUFF CREEK DR, CHASKA, MN 55318-9515
(952) 496-9756
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4941
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073671806
MINNESOTA HEALTH CARE PROGRAMS ('MEDICAL ASSISTANCE')
MN
Enumeration date
12/05/2006
Last updated
12/04/2010
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