Individual
MRS. HALEY NICOLE TIPPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1212 CLEAR LAKE RD STE 200, WEATHERFORD, TX 76086-5878
(817) 871-9069
(817) 871-9067
Mailing address
805 ROLLING TERRACE CIR, GRANBURY, TX 76049-7875
(817) 996-4186
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA16698
TX
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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